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Published in: BMC Surgery 1/2016

Open Access 01-12-2016 | Research article

Proteinuria can predict prognosis after liver transplantation

Authors: Heng-Chih Pan, Ying-Jen Chen, Jhe-Ping Lin, Ming-Jung Tsai, Chang-Chyi Jenq, Wei-Chen Lee, Ming-Hung Tsai, Pei-Chun Fan, Chih-Hsiang Chang, Ming-Yang Chang, Ya-Chung Tian, Cheng-Chieh Hung, Ji-Tseng Fang, Chih-Wei Yang, Yung-Chang Chen

Published in: BMC Surgery | Issue 1/2016

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Abstract

Background

Proteinuria is a manifestation of renal dysfunction and it has been demonstrated to be a significant prognostic factor in various clinical situations. The study was designed to analyze prognosis of patients receiving liver transplantation as well as to determine predictive performance of perioperative proteinuria.

Methods

We retrospectively reviewed data of patients who had received a liver transplant in a medical center between 2002 and 2010. Demographic information and clinical characteristic parameters were recorded on the day of intensive care unit admission before operation and on postoperative days 1, 7, and 14.

Results

Among a total of 323 patients, in-hospital mortality and 90-day mortality rates were 13.0 % (42/323) and 14.2 % (46/323), respectively. Patients with proteinuria on admission had higher rates of acute kidney injury (26.8 % vs. 8.8 %, p < 0.001), severe infection episodes (48.8 % vs. 30.7 %, p = 0.023), hospital death (31.1 % vs. 10.1 %, p < 0.001), and 90-day mortality (37.7 % vs. 10.9 %, p < 0.001). Multivariate analysis showed that proteinuria on admission and Sequential Organ Failure Assessment (SOFA) score were independent predictors of in-hospital mortality. The discriminatory ability of proteinuria plus SOFA was even better than that of SOFA alone, especially on postoperative day 1.

Conclusions

The presence of proteinuria before liver transplantation is supposed to be recognized as a negative predictor for in-hospital survival. Moreover, the presence of proteinuria after liver transplantation can assist in the early prediction of poor short-term prognosis for patients receiving liver transplantation.
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Metadata
Title
Proteinuria can predict prognosis after liver transplantation
Authors
Heng-Chih Pan
Ying-Jen Chen
Jhe-Ping Lin
Ming-Jung Tsai
Chang-Chyi Jenq
Wei-Chen Lee
Ming-Hung Tsai
Pei-Chun Fan
Chih-Hsiang Chang
Ming-Yang Chang
Ya-Chung Tian
Cheng-Chieh Hung
Ji-Tseng Fang
Chih-Wei Yang
Yung-Chang Chen
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2016
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-016-0176-8

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