Acute Kidney injury following liver transplantation: a systematic review of published predictive models

Caragata, R., Wyssusek, K. H. and Kruger, P. (2016) Acute Kidney injury following liver transplantation: a systematic review of published predictive models. Anaesthesia and Intensive Care, 44 2: 251-261.

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Author Caragata, R.
Wyssusek, K. H.
Kruger, P.
Title Acute Kidney injury following liver transplantation: a systematic review of published predictive models
Journal name Anaesthesia and Intensive Care   Check publisher's open access policy
ISSN 0310-057X
1448-0271
Publication date 2016-03
Sub-type Critical review of research, literature review, critical commentary
Open Access Status Not Open Access
Volume 44
Issue 2
Start page 251
End page 261
Total pages 11
Place of publication North Sydney, NSW, Australia
Publisher Australian Society of Anaesthetists
Collection year 2017
Language eng
Abstract Acute kidney injury (AKI) is a frequent postoperative complication amongst liver transplant recipients and is associated with increased morbidity and mortality. This systematic review analysed the existing predictive models, in order to solidify current understanding. Articles were selected for inclusion if they described the primary development of a clinical prediction model (either an algorithm or risk score) to predict AKI post liver transplantation. The database search yielded a total of seven studies describing the primary development of a prediction model or risk score for the development of AKI following liver transplantation. The models span thirteen years of clinical research and highlight a gradual change in the definitions of AKI, emphasising the need to employ standardised definitions for subsequent studies. Collectively, the models identify a diverse range of predictive factors with several common trends. They emphasise the impact of preoperative renal dysfunction, liver disease severity and aetiology, metabolic risk factors as well as intraoperative variables including measures of haemodynamic instability and graft quality. Although several of the models address postoperative parameters, their utility in predictive modelling seems to be of questionable relevance. The common risk factors identified within this systematic review provide a minimum list of variables, which future studies should address. Research in this area would benefit from prospective, multisite studies with larger cohorts as well as the subsequent internal and external validation of predictive models. Ultimately, the ability to identify patients at high risk of post-transplant AKI may enable early intervention and perhaps prevention.
Keyword Acute kidney injury
Liver transplantation
Prediction model
Risk score
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
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Created: Wed, 23 Mar 2016, 22:48:46 EST by Dr Kerstin Wyssusek on behalf of Anaesthesiology and Critical Care - PAH