Intraoperative Normal Saline Administration and Acute Kidney Injury in Patients Undergoing Liver Transplantation

Seoul National University

Status: Unknown

Conditions: Liver Transplant; Complications; Liver Cirrhosis; End Stage Liver DIsease

Treatments: Drug: Balanced crystalloid solution; Drug: Normal saline

Study type: Observational

Funder types: Other

Identifiers

NCT05386953

H-2108-173-1248

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 1,440 estimated patients

Sex: All

Ages: 20+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Consecutive patients who underwent living or deceased donor liver transplantation at our tertiary care university hospital between 2004 and 2018

Exclusion criteria

• patients with baseline renal dysfunction of hepatorenal syndrome or chronic kidney disease
• missing preoperative serum creatinine value
• missing other baseline or outcome variables
• patients who received retransplantation

Trial design

1,440 participants in 2 patient groups

Balanced group

Description:

Patients who received balanced crystalloids of lactated Ringer's solution or plasma solution during liver transplantation surgery

Treatment:

Drug: Balanced crystalloid solution

Saline group

Description:

Patients who received only normal saline during liver transplantation surgery

Treatment:

Drug: Normal saline