Korean J Transplant.  2022 Nov;36(Supple 1):S117. 10.4285/ATW2022.F-2358.

Continues renal replacement therapy in acute kidney injury after liver transplantation in National Cancer Center of Mongolia

• Magsar S
• Sumiya S
• Bayrsaikhan E

• KMID: 2535633
• DOI: http://doi.org/10.4285/ATW2022.F-2358

Abstract

Background
Liver transplantation has become a widely accepted treatment for a variety of liver diseases, such as viral and alcoholic cirrhosis, liver malignancy, acute liver failure, and many metabolic abnormalities.
Methods
We have performed 60 liver transplantation (LT) in National Cancer Center of Mongolia (NCCM) in our hospital. Fifty cases on living donor LT (LDLT), 10 cases are deceased donor LT (DDLT). After LT, seven patients have acute kidney injury (AKI), we used CRRT six trouble condition patient. Since January 2018, 7/60 (11.6%) patients entered in the CRRT. The primary reasons for the initiation of (CRRT) were treatment of fluid overload, electrolyte imbalance, acidosis, anuria, sepsis and renal failure.
Results
Seven patients are (100%) survived now. For example, the patient, 44-year-old male diagnosed with hepatocellular carcinoma in liver with cirrhosis, portal hypertension, ascites, and hepatorenal syndrome. Pre-surgical lab; blood test, WBC-4.5, RBC-3,8 HGB-13.1, HCT-38.3, PLT-53. Biochemistry; Alibumin-30.0, BUN-13.8, T protein-55.3, ALAT-62.8, ASAT-89.5, T Bil-irubin-46, Cretinin-217.2, Na-141, K-4.2. LDLT was successfully done. The operation time was 9 hours. Blood loss was 400 mL, intraoperative fluid: transfused blood was 490, plasma solution 18,000, urine output is 600 mL. vasopressin and noradrenalin received. When admitted to the ICU intubated, postoperation laboratory results are increased, BUN 24 mmol/L, creatinine 333mmol/L, hyperkalemia 6.9 mmol/L, pulmonary, all body edema, urine output is decreased to 20 mL/hr. We connected CRRT 48 hours, ultrafiltrated 100 mL/hr. After CRRT patient condition and laboratory results are increased, urine output increased to 70 mL/hr, creatinine and bun are measured normal range, no edema.
Conclusions
We performed CRRT in NCC, first time. Critically ill patients with AKI are often treated with CRRT. Although it is pre-sumed that it offers patients the benefits of greater hemodynamic stability, metabolic clearance, and volume control, random- ized clinical trials comparing CRRT to intermittent modalities have failed to demonstrate its superiority in terms of survival.