Continuous venovenous hemodialysis treatment in critically ill patients after liver transplantation

Continuous venovenous hemodialysis treatment in critically ill patients aft er liver transplantation. Background. Acute renal failure (ARF) in critically ill patients is associa ted with a high mortality rate. Continuous renal replacement therapy (CRRT) is now widely used for the treatment of ARF in these critically ill patien ts. We retrospectively analyzed the role of CRRT as a prognostic parameter in patients receiving a cadaveric liver graft in 1998. Methods. We reviewed the patient records of all adult recipi ents of a cada veric liver graft (N = 54) in 1998 and compared those who underwent CRRT tr eatment (N = 19) to those without CRRT treatment (N = 35). Results. Mortality was high in the continuous venovenous hemodialysis (CVVH D) group (58%). At the time of transplantation, creatinine (1.7 +/- 0.4 vs. 1.0 +/- 0.1 mg/dl), blood urea nitrogen (40 +/- 13 vs. 22 +/- 3 mg/dl), as partate aminotransferase (ASAT; 585 +/- 420 vs. 242 +/- 97 U/liter), and bi lirubin (11.6 +/- 4.1 vs. 6.5 +/- 1.9 mg/dl) were higher in the CVVHD group than in controls, whereas hemoglobin (10.3 +/- 0.6 vs. 10.8 +/- 0.4 g/dl), white blood cells (6.3 +/- 0.6 vs. 7.0 +/- 0.8/nl), and thrombocytes (110 +/- 18 vs. 90 +/- 10/nl) were similar. After transplantation, liver graft f unction was impaired in the CVVHD group as compared with controls. Conclusions. The necessity for CRRT in patients after liver transplantation correlates with a high risk of death. Thus, more efforts have to be made t o prevent renal failure in patients after liver transplantation.