{"title":"慢性丙型肝炎病毒对活体肝移植后急性肾损伤的影响","authors":"Jae Hwan Kim,Kyoung-Sun Kim,Hye-Mee Kwon,Sung-Hoon Kim,In-Gu Jun,Jun-Gol Song,Gyu-Sam Hwang","doi":"10.1213/ane.0000000000007253","DOIUrl":null,"url":null,"abstract":"BACKGROUND\r\nAcute kidney injury (AKI) is one of the most common complications after liver transplantation (LT) and can significantly impact outcomes. The presence of hepatitis C virus (HCV) infection increases the risk of AKI development. However, the impact of HCV on AKI after LT has not been evaluated. The aim of this study was to assess the effect of HCV on AKI development in patients who underwent LT.\r\n\r\nMETHODS\r\nBetween January 2008 and April 2023, 2183 patients who underwent living donor LT (LDLT) were included. Patients were divided into 2 groups based on the presence of chronic HCV infection. We compared LT recipients using the propensity score matching (PSM) method. Factors associated with AKI development were evaluated using multiple logistic regression analysis. In addition, 1-year mortality and graft failure were assessed using a Cox proportional regression model.\r\n\r\nRESULTS\r\nAmong 2183 patients, the incidence of AKI was 59.2%. After PSM, the patients with HCV showed a more frequent development of AKI (71.9% vs 63.9%, P = .026). In multivariate analysis after PSM, HCV was associated with AKI development (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.06-2.20, P = .022), 1-year mortality (Hazard ratio [HR], 1.98; 95% CI, 1.12-3.52, P = .019), and graft failure (HR, 2.12; 95% CI, 1.22-3.69, P = .008).\r\n\r\nCONCLUSIONS\r\nThe presence of HCV was associated with increased risk for the development of AKI, 1-year mortality, and graft failure after LT.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"18 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of Chronic Hepatitis C Virus on Acute Kidney Injury After Living Donor Liver Transplantation.\",\"authors\":\"Jae Hwan Kim,Kyoung-Sun Kim,Hye-Mee Kwon,Sung-Hoon Kim,In-Gu Jun,Jun-Gol Song,Gyu-Sam Hwang\",\"doi\":\"10.1213/ane.0000000000007253\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND\\r\\nAcute kidney injury (AKI) is one of the most common complications after liver transplantation (LT) and can significantly impact outcomes. The presence of hepatitis C virus (HCV) infection increases the risk of AKI development. However, the impact of HCV on AKI after LT has not been evaluated. The aim of this study was to assess the effect of HCV on AKI development in patients who underwent LT.\\r\\n\\r\\nMETHODS\\r\\nBetween January 2008 and April 2023, 2183 patients who underwent living donor LT (LDLT) were included. Patients were divided into 2 groups based on the presence of chronic HCV infection. We compared LT recipients using the propensity score matching (PSM) method. Factors associated with AKI development were evaluated using multiple logistic regression analysis. In addition, 1-year mortality and graft failure were assessed using a Cox proportional regression model.\\r\\n\\r\\nRESULTS\\r\\nAmong 2183 patients, the incidence of AKI was 59.2%. After PSM, the patients with HCV showed a more frequent development of AKI (71.9% vs 63.9%, P = .026). In multivariate analysis after PSM, HCV was associated with AKI development (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.06-2.20, P = .022), 1-year mortality (Hazard ratio [HR], 1.98; 95% CI, 1.12-3.52, P = .019), and graft failure (HR, 2.12; 95% CI, 1.22-3.69, P = .008).\\r\\n\\r\\nCONCLUSIONS\\r\\nThe presence of HCV was associated with increased risk for the development of AKI, 1-year mortality, and graft failure after LT.\",\"PeriodicalId\":7799,\"journal\":{\"name\":\"Anesthesia & Analgesia\",\"volume\":\"18 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-10-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anesthesia & Analgesia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1213/ane.0000000000007253\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anesthesia & Analgesia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1213/ane.0000000000007253","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景急性肾损伤(AKI)是肝移植(LT)后最常见的并发症之一,会严重影响治疗效果。丙型肝炎病毒(HCV)感染会增加急性肾损伤发生的风险。然而,HCV 对 LT 后 AKI 的影响尚未得到评估。方法2008年1月至2023年4月间,纳入了2183名接受活体捐献LT(LDLT)的患者。根据是否存在慢性 HCV 感染将患者分为两组。我们采用倾向得分匹配法(PSM)对LT受者进行了比较。采用多元逻辑回归分析评估了与 AKI 发生相关的因素。结果2183名患者中,AKI发生率为59.2%。PSM 后,HCV 患者发生 AKI 的频率更高(71.9% vs 63.9%,P = .026)。在 PSM 后的多变量分析中,HCV 与 AKI 发生率(几率比 [OR],1.53;95% 置信区间 [CI],1.06-2.20,P = .022)、1 年死亡率(危险比 [HR],1.98;95% 置信区间 [CI],1.12-3.52,P = .019)相关。结论HCV的存在与LT后发生AKI、1年死亡率和移植物失败的风险增加有关。
Impact of Chronic Hepatitis C Virus on Acute Kidney Injury After Living Donor Liver Transplantation.
BACKGROUND
Acute kidney injury (AKI) is one of the most common complications after liver transplantation (LT) and can significantly impact outcomes. The presence of hepatitis C virus (HCV) infection increases the risk of AKI development. However, the impact of HCV on AKI after LT has not been evaluated. The aim of this study was to assess the effect of HCV on AKI development in patients who underwent LT.
METHODS
Between January 2008 and April 2023, 2183 patients who underwent living donor LT (LDLT) were included. Patients were divided into 2 groups based on the presence of chronic HCV infection. We compared LT recipients using the propensity score matching (PSM) method. Factors associated with AKI development were evaluated using multiple logistic regression analysis. In addition, 1-year mortality and graft failure were assessed using a Cox proportional regression model.
RESULTS
Among 2183 patients, the incidence of AKI was 59.2%. After PSM, the patients with HCV showed a more frequent development of AKI (71.9% vs 63.9%, P = .026). In multivariate analysis after PSM, HCV was associated with AKI development (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.06-2.20, P = .022), 1-year mortality (Hazard ratio [HR], 1.98; 95% CI, 1.12-3.52, P = .019), and graft failure (HR, 2.12; 95% CI, 1.22-3.69, P = .008).
CONCLUSIONS
The presence of HCV was associated with increased risk for the development of AKI, 1-year mortality, and graft failure after LT.