Intraoperative Hepatic Blood Inflow Can Predict Early Acute Kidney Injury following DCD Liver Transplantation: A Retrospective Observational Study

Table 1

Patients characteristics and perioperative parameters by KDIGO classification.

Characteristics	Development cohort (n=105)			Validation cohort (n=27)
	non-EAKI (n=74)	EAKI (n=31)	P value	non-EAKI (n=21)	EAKI (n=6)	P value
Demographic data
Age, years	50 43-57	53 48-58	0.066	48 42-53	52 45-60	0.458
Female, n	17 (23.0)	7 (22.6)	0.965	6 (28.6)	2 (33.3)	1.000
Height, cm	170 165-175	170 165-175	0.816	172 170-176	173 163-177	0.716
Weight, kg	65 58-77	65 60-75	0.737	68 62-74	66 63-69	0.533
BMI, kg/m^2	22.9 20.4-26.1	22.2 21.7-24.4	0.645	22.3 21.5-23.8	23.3 22.0-24.3	0.971
BSA, m^2	1.76 1.63-1.91	1.77 1.65-1.91	0.778	1.81 1.72-1.92	1.81 1.69-1.84	0.619
Background medical status
Hypertension, n	4 (5.4)	2 (6.5)	0.802	0 (0.0)	1 (16.7)	0.222
Diabetes mellitus, n	9 (12.2)	6 (19.4)	0.512	4 (19.0)	2 (33.3)	0.588
Smoking, n	16 (21.6)	9 (29.0)	0.416	6 (28.6)	2 (33.3)	1.000
Alcoholic liver cirrhosis, n	5 (6.8)	1 (3.2)	0.802	1 (4.8)	1 (16.7)	0.402
HBV hepatitis, n	52 (70.3)	22 (71.0)	0.943	12 (57.1)	4 (66.6)	1.000
HCV hepatitis, n	7 (9.5)	2 (6.5)	0.904	2 (9.5)	1 (16.7)	0.545
Liver tumor, n	31 (41.9)	6 (19.4)	0.027	6 (28.6)	0 (0.0)	0.284
Cholestatic disease, n	6 (8.1)	5 (16.1)	0.382	2 (9.5)	0 (0.0)	1.000
Hepatic encephalopathy, n	12 (16.2)	10 (32.3)	0.065	2 (9.5)	1 (16.7)	0.545
Serum albumin level, g/L	31.5 27.5-36.0	30.0 25.5-32.4	0.122	36.1 31.5-38.1	32.7 27.8-37.8	0.585
Total bilirubin, μmol/L	33.7 20.1-75.5	78.1 39.3-273.9	0.003	39.7 21.9-99.7	136.3 103.5-191.4	0.031
Prothrombin time, s	18.6 15.7-25.1	21.4 18.3-25.7	0.152	17.0 15.3-19.4	25.1 22.3-28.3	0.010
MELD score	12.6 9.1-20.9	17.8 12.6-21.8	0.015	13.2 9.4-18.6	21.5 20.4-24.9	0.031
CTP score	9 7-11	10 10-11	0.003	8 6-9	10 10-11	0.012
Child class, n (A/ B/ C)	16/24/34	1/8/22	0.020	7/9/5	0/0/6	0.003
Baseline renal function
Preoperative serum creatinin, μmol/L	62.0 52.3-74.8	65.0 54.0-78.5	0.421	61.0 53.0-95.0	56.0 51.3-57.8	0.122
Preoperative estimated	129.6	118.5	0.369	108.8	154.6	0.092
GFR, ml/min/1.73 m^2	105.0-161.7	98.9-147.7		78.4-152.6	139.7-172.7
Preoperative blood urea	5.20	4.80	0.464	5.94	3.75	0.216
nitrogen, mmol/L	4.00-7.17	4.10-6.29		4.83-6.50	3.01-5.66
Donor liver factors
Warm ischemic time, s	180 150-180	180 150-195	0.623	270 180-300	300 210-300	0.630
Cold ischemic time, min	493 413-554	540 445-647	0.028	440 385-510	418 385-540	0.883
Operation and anesthesia details
Operation time, min	533 480-600	590 530-678	0.015	540 480-600	570 518-690	0.357
Anhepatic phase, min	103 90-116	112 107-136	0.002	80 75-92	95 92-103	0.152
Norepinephrine use, n	6 (8.1)	4 (12.9)	0.690	1 (4.8)	0 (0.0)	1.000
pRBC transfusion, mL	2800 1275-4400	4800 2200-6450	0.005	3200 2000-4800	4800 2650-7400	0.255
FFP transfusion, mL	1000 600-1950	1400 900-2700	0.066	1200 550-2000	2650 1150-4000	0.129
Platelet transfusion, units	0 0-0	0 0-0	0.357	0 0-1	0 0-2	0.857
Cryoprecipitate transfusion, units	0 0-10	10 0-10	0.035	0 0-20	15 3-20	0.378
PVF, mL/min	1730 1385-2237	1444 1068-1898	0.015	1670 1200-2400	1122 1023-1183	0.036
PVF/height, mL/min/cm	10.12 8.35-13.22	8.11 6.33-10.76	0.012	9.82 7.26-13.34	6.575 6.06-7.04	0.026
PVF/weight, mL/min/kg	27.59 20.26-34.92	20.23 17.45-28.50	0.013	26.94 20.40-33.75	16.86 15.48-18.16	0.026
PVF/BMI, m^2·mL/min/kg	76.72 58.29-104.11	61.94 48.33-77.44	0.018	77.86 58.54-103.36	47.66 42.70-53.52	0.036
PVF/BSA, mL/min/m^2	1000.0 779.2-1243.4	788.0 643.1-1029.2	0.009	970.9 734.3-1279.9	627.7 588.4-681.2	0.015
HAF, mL/min	149.0 106.8-214.5	165.0 106.2-215.5	0.905	226.0 142.0-280.0	167.0 113.4-214.6	0.431
HAF/height, mL/min/cm	0.86 0.62-1.24	0.98 0.61-1.23	0.905	1.28 0.81-1.60	0.94 0.70-1.20	0.254
HAF/weight, mL/min/kg	2.20 1.63-3.22	2.49 1.47-3.12	0.886	3.21 2.26-4.31	2.47 1.76-3.09	0.408
HAF/BMI, m^2·mL/min/kg	6.38 4.50-8.88	7.00 4.07-9.62	0.855	9.39 5.96-12.74	7.57 4.67-10.13	0.196
HAF/BSA, mL/min/m^2	83.38 58.27-122.63	96.13 54.88-116.29	0.902	134.64 74.47-153.37	91.16 66.86-114.27	0.260
HBI, mL/min	1899 1570-2457	1656 1215-2082	0.015	2170 1480-2575	1260 1224-1318	0.042
HBI/height, mL/min/cm	11.32 9.43-14.32	9.30 7.23-11.99	0.010	12.76 9.22-14.97	7.62 7.39-7.80	0.036
HBI/weight, mL/min/kg	30.05 22.00-38.91	24.01 19.33-31.79	0.014	29.63 23.77-36.68	19.61 18.71-20.20	0.049
HBI/BMI, m^2·mL/min/kg	86.84 63.64-111.89	68.71 51.98-88.65	0.014	94.36 68.69-111.31	54.67 49.78-58.68	0.044
HBI/BSA, mL/min/m^2	1098.6 895.2-1377.7	850.0 702.8-1158.1	0.006	1207.3 858.9-1418.1	731.1 705.9-762.8	0.036
Urine volume, mL	1300 800-2000	1300 725-1725	0.621	1300 750-2000	1000 650-1180	0.515
Postoperative factors
Tacrolimus use, n	71 (95.9)	31 (100.0)	0.553	20 (95.2)	6 (100.0)	1.000
Cyclosporine use, n	3 (4.1)	0 (0.0)	0.553	1 (4.8)	0 (0.0)	1.000

BMI = body-mass index; BSA = body surface area; MELD = model for end-stage liver disease; CTP = Child-Turcotte-Pugh; GFR = glomerular filtration rate; pRBC = packed red blood cells; FFP = fresh frozen plasma; PVF = intraoperative mean portal vein flow; HAF = intraoperative mean hepatic artery flow; HBI = intraoperative mean hepatic blood inflow; Warm ischemic time: from no heartbeat to cold perfusion; Cold ischemic time: from cold perfusion to liver blood supply restored.