Low preoperative serum uric acid is associated with early acute kidney injury after living donor liver transplantation

Yueh-Tse Wu; Li-Min Hu; Chao-Wei Lee; Wei-Chen Lee; Jr-Rung Lin; Hsin-I Tsai; Huang-Ping Yu

doi:10.1097/JCMA.0000000000001103

Low preoperative serum uric acid is associated with early acute kidney injury after living donor liver transplantation

J Chin Med Assoc. 2024 May 1. doi: 10.1097/JCMA.0000000000001103. Online ahead of print.

Authors

Yueh-Tse Wu¹, Li-Min Hu^{1

2}, Chao-Wei Lee^{3

4

5}, Wei-Chen Lee^{3

4

5

6}, Jr-Rung Lin^{1

7}, Hsin-I Tsai^{1

3

4}, Huang-Ping Yu^{1

3

4}

Affiliations

¹ Department of Anesthesiology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.
² Division of Medical Education, Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.
³ College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.
⁴ Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan, ROC.
⁵ Department of General Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.
⁶ Department of Liver and Transplant Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.
⁷ Clinical Informatics and Medical Statistics Research Center and Graduate Institute of Clinical Medical Sciences, Department of Biomedical Sciences, Gung Gung University, Taoyuan, Taiwan, ROC.

PMID: 38690873
DOI: 10.1097/JCMA.0000000000001103

Abstract

Background: Liver transplantation is treatment option for patients with end stage liver disease and hepatocellular carcinoma. Renal function deterioration significantly impacts the survival rates of liver recipients, and serum uric acid (SUA) is associated with both acute and chronic renal function disorders. Thus, our study aimed to assess the relationship and predictive value of preoperative SUA level and postoperative acute kidney injury (AKI) in living donor liver transplantation (LDLT).

Methods: We conducted a prospective observational study on 87 patients undergoing LDLT. Blood samples were collected immediately prior to LDLT, and renal function status was followed up for 3 consecutive days postoperatively.

Results: Low SUA levels (cutoff value 4.15 mg/dL) were associated with a high risk of early post-transplantation AKI. The area under the curve was 0.73 (sensitivity, 79.2%; specificity, 59.4%). Although not statistically significant, there were no deaths in the non-AKI group but two in the early AKI group secondary to liver graft dysfunction in addition to early AKI within the first month after LDLT.

Conclusion: AKI after liver transplantation may lead to a deterioration of patient status and increased mortality rates. We determined low preoperative SUA levels as a possible risk factor for early postoperative AK.