Chetana Lim1, Etienne Audureau2, Chady Salloum3, Eric Levesque4, Eylon Lahat3, Jean Claude Merle5, Philippe Compagnon6, Gilles Dhonneur5, Cyrille Feray7, Daniel Azoulay8. 1. Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Henri Mondor Hospital, Créteil, France; INSERM, U965, Paris, France. 2. Department of Public Health, Henri Mondor Hospital, Créteil, France. 3. Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Henri Mondor Hospital, Créteil, France. 4. Department of Anesthesia and Liver Intensive Care Unit, Henri Mondor Hospital, Créteil, France; INSERM, U955, Créteil, France. 5. Department of Anesthesia and Liver Intensive Care Unit, Henri Mondor Hospital, Créteil, France. 6. Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Henri Mondor Hospital, Créteil, France; INSERM, U955, Créteil, France. 7. INSERM, U955, Créteil, France; Department of Hepatology, Henri Mondor Hospital, Créteil, France. 8. Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Henri Mondor Hospital, Créteil, France; INSERM, U955, Créteil, France. Electronic address: daniel.azoulay@hmn.aphp.fr.
Abstract
BACKGROUND: Acute kidney injury (AKI) following hepatectomy remains understudied in terms of diagnosis, severity, recovery and prognostic value. The aim of this study was to assess the risk factors and prognostic value of AKI on short- and long-term outcomes following hepatectomy for hepatocellular carcinoma (HCC). METHOD: This is a retrospective analysis of a single-center cohort of 457 consecutive patients who underwent hepatectomy for HCC. The KDIGO criteria were used for AKI diagnosis. The incidence, risk factors, and prognostic value of AKI were investigated. RESULTS: AKI occurred in 67 patients (15%). The mortality and major morbidity rates were significantly higher in patients with AKI (37% and 69%) than in those without (6% and 22%; p < 0.001). Renal recovery was complete in 35 (52%), partial in 25 (37%), and absent in 7 (11%) patients. Advanced age, an increased MELD score, major hepatectomy and prolonged duration of operation were identified as independent predictors of AKI. AKI was identified as the strongest independent predictor of postoperative mortality but did not impact survival. CONCLUSION: AKI is a common complication after hepatectomy for HCC. Although its development is associated with poor short-term outcomes, it does not appear to be predictive of impaired long-term survival.
BACKGROUND:Acute kidney injury (AKI) following hepatectomy remains understudied in terms of diagnosis, severity, recovery and prognostic value. The aim of this study was to assess the risk factors and prognostic value of AKI on short- and long-term outcomes following hepatectomy for hepatocellular carcinoma (HCC). METHOD: This is a retrospective analysis of a single-center cohort of 457 consecutive patients who underwent hepatectomy for HCC. The KDIGO criteria were used for AKI diagnosis. The incidence, risk factors, and prognostic value of AKI were investigated. RESULTS: AKI occurred in 67 patients (15%). The mortality and major morbidity rates were significantly higher in patients with AKI (37% and 69%) than in those without (6% and 22%; p < 0.001). Renal recovery was complete in 35 (52%), partial in 25 (37%), and absent in 7 (11%) patients. Advanced age, an increased MELD score, major hepatectomy and prolonged duration of operation were identified as independent predictors of AKI. AKI was identified as the strongest independent predictor of postoperative mortality but did not impact survival. CONCLUSION: AKI is a common complication after hepatectomy for HCC. Although its development is associated with poor short-term outcomes, it does not appear to be predictive of impaired long-term survival.
Authors: Paolo Angeli; Pere Gines; Florence Wong; Mauro Bernardi; Thomas D Boyer; Alexander Gerbes; Richard Moreau; Rajiv Jalan; Shiv K Sarin; Salvatore Piano; Kevin Moore; Samuel S Lee; Francois Durand; Francesco Salerno; Paolo Caraceni; W Ray Kim; Vicente Arroyo; Guadalupe Garcia-Tsao Journal: Gut Date: 2015-01-28 Impact factor: 23.059
Authors: Glenn M Chertow; Elisabeth Burdick; Melissa Honour; Joseph V Bonventre; David W Bates Journal: J Am Soc Nephrol Date: 2005-09-21 Impact factor: 10.121
Authors: Ibtesam A Hilmi; Daniela Damian; Ali Al-Khafaji; Tetsuro Sakai; Joseph Donaldson; Daniel G Winger; John A Kellum Journal: Liver Transpl Date: 2015-07-21 Impact factor: 5.799
Authors: Azra Bihorac; Sinan Yavas; Sophie Subbiah; Charles E Hobson; Jesse D Schold; Andrea Gabrielli; A Joseph Layon; Mark S Segal Journal: Ann Surg Date: 2009-05 Impact factor: 12.969
Authors: Azra Bihorac; Meghan Brennan; Tezcan Ozrazgat-Baslanti; Shahab Bozorgmehri; Philip A Efron; Frederick A Moore; Mark S Segal; Charles E Hobson Journal: Crit Care Med Date: 2013-11 Impact factor: 7.598
Authors: Swee H Teh; John Christein; John Donohue; Florencia Que; Michael Kendrick; Michael Farnell; Stephen Cha; Patrick Kamath; Raymond Kim; David M Nagorney Journal: J Gastrointest Surg Date: 2005-12 Impact factor: 3.267
Authors: Alexsander K. Bressan; Matthew T. James; Elijah Dixon; Oliver F. Bathe; Francis R. Sutherland; Chad G. Ball Journal: Can J Surg Date: 2018-10-01 Impact factor: 2.089
Authors: Sven H Loosen; Frank Tacke; Marcel Binnebosel; Catherine Leyh; Mihael Vucur; Florian Heitkamp; Wenzel Schoening; Tom F Ulmer; Patrick H Alizai; Christian Trautwein; Alexander Koch; Thomas Longerich; Christoph Roderburg; Ulf P Neumann; Tom Luedde Journal: Oncotarget Date: 2018-06-05
Authors: Sven H Loosen; Annemarie Breuer; Frank Tacke; Jakob N Kather; Joao Gorgulho; Patrick H Alizai; Jan Bednarsch; Anjali A Roeth; Georg Lurje; Sophia M Schmitz; Jonathan F Brozat; Pia Paffenholz; Mihael Vucur; Thomas Ritz; Alexander Koch; Christian Trautwein; Tom F Ulmer; Christoph Roderburg; Thomas Longerich; Ulf P Neumann; Tom Luedde Journal: JHEP Rep Date: 2020-01-31