دورية أكاديمية
Impact of acute kidney injury response on survival and liver transplant rates in hospitalized patients with cirrhosis awaiting liver transplantation: Results from the HRS-HARMONY consortium.
| العنوان: | Impact of acute kidney injury response on survival and liver transplant rates in hospitalized patients with cirrhosis awaiting liver transplantation: Results from the HRS-HARMONY consortium. |
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| المؤلفون: | Li X; Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Ouyang T; Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Belcher JM; Section of Nephrology, Department of Internal Medicine, Yale University and VA Connecticut Healthcare, New Haven, CT., Patidar KR; Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX., Cullaro G; Division of Gastroenterology, University of California, San Francisco, CA., Asrani SK; Baylor University Medical Center, Dallas, TX., Wadei H; Department of Transplantation, Mayo Clinic, Jacksonville, FL., Simonetto DA; Division of Gastroenterology and Transplant Hepatology, Mayo Clinic, Rochester, Rochester, MN., Regner KR; Division of Nephrology at the Medical College of Wisconsin, Milwaukee, WI., Dageforde LA; Department of Surgery, Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA., Przybyszewski EM; Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Wilechansky RM; Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Sharma P; Department of Gastroenterology and Transplant Hepatology at University of Michigan Health, Ann Arbor, MI., Ufere NN; Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Duarte-Rojo A; Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University, Chicago, IL., Wahid NA; Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University, Chicago, IL., Orman ES; Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX., St Hillien SA; Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Robinson JE; Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Chung RT; Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA., Allegretti AS; Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, MA. |
| مؤلفون مشاركون: | HRS-HARMONY research collaborative |
| المصدر: | Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society [Liver Transpl] 2024 Jul 30. Date of Electronic Publication: 2024 Jul 30. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 100909185 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-6473 (Electronic) Linking ISSN: 15276465 NLM ISO Abbreviation: Liver Transpl Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2023- : [Philadelphia] : Wolters Kluwer Health, Inc. Original Publication: Philadelphia, PA : W.B. Saunders Co., c2000- |
| مستخلص: | Background & Aims: Acute kidney injury (AKI) frequently complicates the course of hospitalized patients with cirrhosis and negatively affects their prognosis. How AKI response influences the timing of liver transplantation (LT) remains unclear. We sought to assess the impact of AKI response to treatment on survival and LT rates in cirrhosis patients awaiting LT. Approach & Results: This was a retrospective multicenter study of cirrhosis patients waitlisted for LT and hospitalized with AKI in 2019. The exposure was AKI response versus no response during hospitalization. Outcomes were 90-day overall and transplant-free survival, and rates of LT with time to transplant. We adjusted for age, sex, race, cirrhosis etiology, site, and MELD-Na score. Among the 317 patients in this study, 170 had AKI response (53.6%), and 147 had no response (46.4%). Compared to non-responders, responders had better 90-day overall survival (89.4% vs. 76.2%, adjusted sHR for mortality 0.34, p=0.001), and transplant-free survival (63.5% vs. 25.2%, aHR for probability of death or transplant 0.35, p<0.001). The LT rate was lower in responders (45.9% vs. 61.2%, adjusted sHR 0.55, p=0.005). 79% of transplants in responders occurred after discharge, at a median of 103 days, while 62% of transplants in non-responders occurred during hospitalization, with the remainder occurring post-discharge at a median of 58 days. Conclusions: In patients with cirrhosis waitlisted for LT who are hospitalized with AKI, AKI response to therapy is associated with improved 90-day survival, despite a reduced LT rate and longer time to LT. (Copyright © 2024 American Association for the Study of Liver Diseases.) |
| معلومات مُعتمدة: | K23 AA031068 United States AA NIAAA NIH HHS |
| تواريخ الأحداث: | Date Created: 20240729 Latest Revision: 20240814 |
| رمز التحديث: | 20240814 |
| DOI: | 10.1097/LVT.0000000000000445 |
| PMID: | 39073567 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1527-6473 |
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| DOI: | 10.1097/LVT.0000000000000445 |