Acute kidney injury in liver transplant candidates: A position paper on behalf of the Liver Intensive Care Group of Europe

Paolo Angeli, Dimitri Bezinover, Gianni Biancofiore, Anja Bienholz, James Findlay, Catherine Paugam Burtz, Koen Reyntjens, Tetsuro Sakai, Fuat H. Saner, Dana Tomescu, Gebhard Wagener, Emmanuel Weiss

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

INTRODUCTION: Acute kidney injury is associated with high mortality in the perioperative period of liver transplantation. The aim of this position paper was to provide an up-to-date overview with special emphases on diagnosis, risk factors, and treatment. EVIDENCEACQUISITION: The Liver Intensive Care Group of Europe nominated a panel of recognized international experts who reviewed the available literature published from 1990 to January 2016 and produced clinical recommendations. The level of evidence and strength of recommendation were judged according to the Grading of Recommendations Assessment Development and Evaluation system. EVIDENCESYNTHESIS: Diagnosis of AKIshould be based on the KDIGOcriteria. The preoperative risk factors are more related to the patients predisposing factors and post-operative risk factors tend to be difficult to control. Therefore, focusing on intra-operative risk factors it would be important to maintain an adequate hemodynamics and to keep inferior vena cava clamping as short as possible. Biomarkers to identify AKIat an early stage are available; however, there is a lack of robust data that indicates their true beneficial effect. Intraoperative renal replacement therapy may be beneficial in some selective cases whereas its postoperative timing is still under debate. CONCLUSIONS: Perioperative liver transplant risk factors for acute kidney injury are difficult to control. Therefore, the focus should be on intra-operative hemodynamics and nephrotoxic drugs avoidance. Prospective randomized trials are needed to show the beneficial effect of early replacement therapy. In this context, the new biomarkers would be helpful in identifying kidney injury earlier

Original languageEnglish (US)
Pages (from-to)88-101
Number of pages14
JournalMinerva anestesiologica
Volume83
Issue number1
DOIs
StatePublished - Jan 2017

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Acute Kidney Injury
Transplants
Liver
Biomarkers
Hemodynamics
Perioperative Period
Renal Replacement Therapy
Inferior Vena Cava
Secondary Prevention
Constriction
Causality
Liver Transplantation
Kidney
Mortality
Wounds and Injuries
Pharmaceutical Preparations
Therapeutics

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

Angeli, Paolo ; Bezinover, Dimitri ; Biancofiore, Gianni ; Bienholz, Anja ; Findlay, James ; Burtz, Catherine Paugam ; Reyntjens, Koen ; Sakai, Tetsuro ; Saner, Fuat H. ; Tomescu, Dana ; Wagener, Gebhard ; Weiss, Emmanuel. / Acute kidney injury in liver transplant candidates : A position paper on behalf of the Liver Intensive Care Group of Europe. In: Minerva anestesiologica. 2017 ; Vol. 83, No. 1. pp. 88-101.
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title = "Acute kidney injury in liver transplant candidates: A position paper on behalf of the Liver Intensive Care Group of Europe",
abstract = "INTRODUCTION: Acute kidney injury is associated with high mortality in the perioperative period of liver transplantation. The aim of this position paper was to provide an up-to-date overview with special emphases on diagnosis, risk factors, and treatment. EVIDENCEACQUISITION: The Liver Intensive Care Group of Europe nominated a panel of recognized international experts who reviewed the available literature published from 1990 to January 2016 and produced clinical recommendations. The level of evidence and strength of recommendation were judged according to the Grading of Recommendations Assessment Development and Evaluation system. EVIDENCESYNTHESIS: Diagnosis of AKIshould be based on the KDIGOcriteria. The preoperative risk factors are more related to the patients predisposing factors and post-operative risk factors tend to be difficult to control. Therefore, focusing on intra-operative risk factors it would be important to maintain an adequate hemodynamics and to keep inferior vena cava clamping as short as possible. Biomarkers to identify AKIat an early stage are available; however, there is a lack of robust data that indicates their true beneficial effect. Intraoperative renal replacement therapy may be beneficial in some selective cases whereas its postoperative timing is still under debate. CONCLUSIONS: Perioperative liver transplant risk factors for acute kidney injury are difficult to control. Therefore, the focus should be on intra-operative hemodynamics and nephrotoxic drugs avoidance. Prospective randomized trials are needed to show the beneficial effect of early replacement therapy. In this context, the new biomarkers would be helpful in identifying kidney injury earlier",
author = "Paolo Angeli and Dimitri Bezinover and Gianni Biancofiore and Anja Bienholz and James Findlay and Burtz, {Catherine Paugam} and Koen Reyntjens and Tetsuro Sakai and Saner, {Fuat H.} and Dana Tomescu and Gebhard Wagener and Emmanuel Weiss",
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Angeli, P, Bezinover, D, Biancofiore, G, Bienholz, A, Findlay, J, Burtz, CP, Reyntjens, K, Sakai, T, Saner, FH, Tomescu, D, Wagener, G & Weiss, E 2017, 'Acute kidney injury in liver transplant candidates: A position paper on behalf of the Liver Intensive Care Group of Europe', Minerva anestesiologica, vol. 83, no. 1, pp. 88-101. https://doi.org/10.23736/S0375-9393.16.11661-X

Acute kidney injury in liver transplant candidates : A position paper on behalf of the Liver Intensive Care Group of Europe. / Angeli, Paolo; Bezinover, Dimitri; Biancofiore, Gianni; Bienholz, Anja; Findlay, James; Burtz, Catherine Paugam; Reyntjens, Koen; Sakai, Tetsuro; Saner, Fuat H.; Tomescu, Dana; Wagener, Gebhard; Weiss, Emmanuel.

In: Minerva anestesiologica, Vol. 83, No. 1, 01.2017, p. 88-101.

Research output: Contribution to journalReview article

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T1 - Acute kidney injury in liver transplant candidates

T2 - A position paper on behalf of the Liver Intensive Care Group of Europe

AU - Angeli, Paolo

AU - Bezinover, Dimitri

AU - Biancofiore, Gianni

AU - Bienholz, Anja

AU - Findlay, James

AU - Burtz, Catherine Paugam

AU - Reyntjens, Koen

AU - Sakai, Tetsuro

AU - Saner, Fuat H.

AU - Tomescu, Dana

AU - Wagener, Gebhard

AU - Weiss, Emmanuel

PY - 2017/1

Y1 - 2017/1

N2 - INTRODUCTION: Acute kidney injury is associated with high mortality in the perioperative period of liver transplantation. The aim of this position paper was to provide an up-to-date overview with special emphases on diagnosis, risk factors, and treatment. EVIDENCEACQUISITION: The Liver Intensive Care Group of Europe nominated a panel of recognized international experts who reviewed the available literature published from 1990 to January 2016 and produced clinical recommendations. The level of evidence and strength of recommendation were judged according to the Grading of Recommendations Assessment Development and Evaluation system. EVIDENCESYNTHESIS: Diagnosis of AKIshould be based on the KDIGOcriteria. The preoperative risk factors are more related to the patients predisposing factors and post-operative risk factors tend to be difficult to control. Therefore, focusing on intra-operative risk factors it would be important to maintain an adequate hemodynamics and to keep inferior vena cava clamping as short as possible. Biomarkers to identify AKIat an early stage are available; however, there is a lack of robust data that indicates their true beneficial effect. Intraoperative renal replacement therapy may be beneficial in some selective cases whereas its postoperative timing is still under debate. CONCLUSIONS: Perioperative liver transplant risk factors for acute kidney injury are difficult to control. Therefore, the focus should be on intra-operative hemodynamics and nephrotoxic drugs avoidance. Prospective randomized trials are needed to show the beneficial effect of early replacement therapy. In this context, the new biomarkers would be helpful in identifying kidney injury earlier

AB - INTRODUCTION: Acute kidney injury is associated with high mortality in the perioperative period of liver transplantation. The aim of this position paper was to provide an up-to-date overview with special emphases on diagnosis, risk factors, and treatment. EVIDENCEACQUISITION: The Liver Intensive Care Group of Europe nominated a panel of recognized international experts who reviewed the available literature published from 1990 to January 2016 and produced clinical recommendations. The level of evidence and strength of recommendation were judged according to the Grading of Recommendations Assessment Development and Evaluation system. EVIDENCESYNTHESIS: Diagnosis of AKIshould be based on the KDIGOcriteria. The preoperative risk factors are more related to the patients predisposing factors and post-operative risk factors tend to be difficult to control. Therefore, focusing on intra-operative risk factors it would be important to maintain an adequate hemodynamics and to keep inferior vena cava clamping as short as possible. Biomarkers to identify AKIat an early stage are available; however, there is a lack of robust data that indicates their true beneficial effect. Intraoperative renal replacement therapy may be beneficial in some selective cases whereas its postoperative timing is still under debate. CONCLUSIONS: Perioperative liver transplant risk factors for acute kidney injury are difficult to control. Therefore, the focus should be on intra-operative hemodynamics and nephrotoxic drugs avoidance. Prospective randomized trials are needed to show the beneficial effect of early replacement therapy. In this context, the new biomarkers would be helpful in identifying kidney injury earlier

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