Akutna bubrežna ozljeda nakon transplantacije jetre

master's thesis

• Title (english): Acute kidney injury after liver transplantation
• Author: Lucija Franušić
• Mentor: Anna Mrzljak (mentor)
• Committee member: Mladen Knotek (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Anna Mrzljak (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Uvod: Akutna bubrežna ozljeda (AKI eng. acute kidney injury) značajna je komplikacija
transplantacije jetre (TJ), a na njezin razvitak utječu brojni faktori. Ciljevi ovog rada bili su
odrediti učestalost AKI, istražiti njezinu povezanost s faktorima rizika te istražiti njezin
utjecaj na ishod bolesnika nakon transplantacije jetre.
----- Metode: Ova retrospektivno istraživanje uključuje 208 bolesnika koji su podvrgnuti
transplantaciji jetre u KB Merkur u razdoblju od listopada 2014. do listopada 2016. godine.
Podaci su prikupljeni iz medicinske dokumentacije. AKI je definiran kao porast kreatinina
veći od 27 umol/L tijekom prvih 7 dana nakon transplantacije u odnosu na vrijednosti
kreatinina prije transplantacije.
----- Rezultati: Vodeća indikacija za TJ bila je alkoholna bolest jetre (51,4%). Većina
transplantiranih razvila je AKI unutar prvih sedam dana (56,7%). Bolesnici koji su razvili
AKI imali su više vrijednosti BMI, perioperativno primjenjen veći volumen autologne
transfuzije i svježe smrznute plazme, više predtransplantacijske vrijednosti kreatinina, natrija
kao i prognostičkih zbrojeva MELD i MELD-Na. Mortalitet unutar prvih 30 dana iznosio je
8,6%. Nije uočena povezanost između 30-dnevnog moraliteta i razvoja akutne bubrežne
ozljede.
----- Zaključak: Naši podaci pokazuju da je akutnu bubrežnu ozljedu razvije više od polovice
bolesnika nakon transplantacije jetre. Češće se pojavljuje u bolesnika sa smanjenom
bubrežnom funkcijom i terminalnim stadijem jetrene bolesti prije transplantacije. Akutna
bubrežna ozljeda nije povezana s povećanjem mortaliteta unutar 30 dana nakon
transplantacije.

Abstract (english)

Background: Acute kidney injury (AKI) is a significant complication after liver
transplantation (LT) with multiple risk factors. The aims of this study were to determine
incidence of AKI, to identify correlation between AKI and the risk factors and to assess effect
of AKI on patient outcome after LT.
----- Methods: This retrospective study included 208 patients transplanted in KB Merkur between
October 2014 to October 2016. The data was acquired from medical documents. AKI after LT
was defined as an increase in creatinine levels higher than 27 umol/L as compared to
creatinine levels before LT.
----- Results: Majority of recipients (51,4%) were transplanted due to alcoholic liver cirrhosis.
Cumulative incidence of newly developed AKI was 56,7%. Overall risk of AKI development
was associated with higher BMI of recipients, higher doses of autologous transfusion and
frozen fresh plasma administered during operation, higher creatinine and sodium levels and
MELD/MELD-Na scores before the transplantation. Cumulative incidence of 30- day
mortality was 8,6% with higher incidence in patients with arterial hypertension. No
correlation was established between 30-day mortality and development of AKI.
----- Conclusion: Results show that more than half of the transplanted patients develop AKI.
Development of AKI is more common in patents with decreased kidney function and end
stage liver disease. AKI has no correlation to 30- day mortality.

• Keywords: akutna bubrežna ozljeda; transplantacija jetre; komplikacije
• Keywords (english): acute kidney injury; liver transplantation; complications
• Language: croatian
• URN:NBN: urn:nbn:hr:105:858695
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-01-29 10:12:33