The investigators attempted to investigate the association of the type of crystalloid administered during liver transplantation with postoperative clinical outcomes. The investigators hypothesized that the greater amount of normal saline or half-saline administered during liver transplantation might be associated with the increased risk of acute kidney injury compared to the balanced crystalloids.
Liver transplantation requires a long operation time and is often associated with a significant amount of surgical bleeding. It is common for the anesthesiologist to infuse large amounts of fluid or blood products due to bleeding, hemodynamic instability, or ascites drainage. Therefore, in the anesthesia for liver transplantation, optimal management of fluid administration is necessary and the choice of the type of crystalloid may affect the prognosis or the incidence of postoperative complications of patients. The investigators attempted to investigate the association of the type of crystalloid administered during liver transplantation with postoperative clinical outcomes. The investigators hypothesized that the greater amount of normal saline or half-saline administered during liver transplantation might be associated with the increased risk of acute kidney injury compared to the balanced crystalloids.
Study Type
OBSERVATIONAL
Enrollment
1,440
Patients received normal saline as a maintenance crystalloid during liver transplantation surgery.
Patients received balanced crystalloids such as lactated Ringer's solution or Plasma solution as a maintenance crystalloid during liver transplantation surgery.
Seoul National University Hospital
Seoul, South Korea
RECRUITINGAcute kidney injury
The investigators defined acute kidney injury by the KDIGO (Kidney Disease Improving Global Outcomes) criteria, which was determined according to the greatest change in serum creatinine level during the postoperative seven days (Stage 1: more than 1.5-fold; stage 2: more than 2-fold; stage 3: more than 3-fold increase of baseline or increase in SCr to ≥ 4.0 mg/dL or the initiation of renal replacement therapy). The most recent SCr level measured before surgery was collected as a baseline value.
Time frame: the first 7 postoperative days
Incidence of postoperative hemodialysis
the incidence of new-onset postoperative hemodialysis during hospitalization
Time frame: the first month after admission
Early allograft dysfunction
One or more of the following are present within the first 7 postoperative days: total bilirubin ≥ 10 mg/dL, PT (prothrombin time):INR (international normalized ratio)≥ 1.6, or AST (aspartate aminotransferase)/ALT (alanine aminotransferase) \> 2000 IU/L
Time frame: the first 7 postoperative days
In-hospital mortality
all-cause mortality during hospitalization
Time frame: the first month after admission
One-year mortality
all-cause mortality during one year after transplantation
Time frame: one year after transplantation
Length of intensive care unit stay
Length of intensive care unit stay after transplantation
Time frame: the first month after admission
Length of hospital stay
Length of hospital stay after transplantation
Time frame: the first month after admission
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