Introduction OLT recipients who develop multiorgan dysfunction. (1) The

Introduction

Orthotopic
liver transplantation (OLT) is the only definitive therapy for the treatment of
end-stage liver disease. Although most recipients do well and are discharged
within 2 weeks of transplantation, some patients require prolonged
hospitalization, and this can dramatically increase both morbidity and the
costs associated with OLT. Previous studies have demonstrated that a prolonged
hospital stay following OLT most frequently occurs in patients without
immediate bile production, in patients who have received more than 20 U of
platelet transfusions during the transplant operation, in patients with poor
urine output during the immediate post-OLT period, and in OLT recipients who
develop multiorgan dysfunction. (1)

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The
occurrence of AKI in patients undergoing LT is associated with reduced patient
and graft survival not only in the perioperative period but also in the longer term
(2) with reports of 10% progressing to endstage renal failure. (3) AKI reduces
patient survival and leads to increased health care costs because of increased
intensive care and hospital stays (4)Furthermore, increasing evidence supports
the fact that even relatively minor deteriorations in renal function not
requiring RRT are associated with inferior patient and renal outcomes in the
longer term; this underlines the importance of the early identification of at risk
individuals and the need to identify preventative strategies. (5)These
consensus definitions of AKI in the LT population have been validated by
studies in which an increasing severity of renal dysfunction (RIFLE grades R-F
or AKIN stages 1-3) correlated with reduced patient survival. (6)

 

The aim of the present study is to assess
the influence of different perioperative factors associated with prolonged
length of ICU duration following living donor liver transplantation and to
evaluate the effect of duration of ICU to both short term and long term
complications following liver transplantation.

Methods

Study design:

 

 A cross-sectional (retrospective)
study was conducted on patients who underwent liver transplantation at El Manial
Cairo- University Hospital. Most of our patients had underwent living donor
transplantation due to end stage liver disease caused by chronic hepatitis C
(HCV) or HCV complicated by hepatocellular carcinoma. They were 44 males and 5
females, their age ranged from 20 to 59 years old with a mean of (48 ±7.51 SD).

Patients were divided into 2 groups according to the
duration of ICU stay:

Group A: Including patients who needed ICU stay for ? 7
days

Group B: Including patients who were in need for ICU stay
for