• J. Cardiothorac. Vasc. Anesth. · Jan 2022

    Incidence and Predictive Factors of Acute Kidney Injury After Off-pump Lung Transplantation.

    • Rabail Chaudhry, Jonathan P Wanderer, Talha Mubashir, Felix Kork, Jennifer Morse, Rida Waseem, John F Zaki, Andrew D Shaw, Holger K Eltzschig, and Yafen Liang.
    • Department of Anesthesiology, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX.
    • J. Cardiothorac. Vasc. Anesth. 2022 Jan 1; 36 (1): 93-99.

    ObjectivesTo determine the incidence and predictive factors of acute kidney injury (AKI) after off-pump lung transplantation.DesignA retrospective cohort study.SettingThe operating room and intensive care unit.ParticipantsAdult patients who underwent lung transplant without cardiopulmonary bypass or extracorporeal membrane oxygenator between 2006 and 2016 at the Vanderbilt University Medical Center.InterventionsNone.Measurements And Main ResultsThe presence of postoperative AKI was assessed by the Kidney Disease: Improving Global Outcomes criteria in the first seven postoperative days. Multivariate logistic regression analysis was used to determine the independent predictive factors of AKI. One hundred forty-eight patients were included in the final analysis, of whom 63 (42.6%) subsequently developed AKI: 43 (29.0%) stage 1, ten (6.8%) stage 2, and ten (6.8%) stage 3. Patients who had AKI had a longer hospital length of stay (12 days [interquartile range (IQR): 10-17] vs ten days [IQR: 8-12], p < 0.001). For every one-year increase in age, the odds of AKI decreased by 8% (odds ratio [OR] 0.92, 95% confidence interval [CI]: 0.87-0.98, p = 0.008). The odds of having AKI in patients with bilateral lung transplant was lower than patients with unilateral transplant (OR 0.09, 95% CI: 0.01-0.63, p = 0.015). Additionally, a diagnosis of chronic obstructive pulmonary disease increased the odds of AKI by four-fold compared with a diagnosis of idiopathic pulmonary fibrosis (OR 4.73, 95% CI: 1.44-15.56, p = 0.011).ConclusionsAKI is a common complication after off-pump lung transplantation and is associated with increased hospital length of stay. Younger age, unilateral lung transplant, and diagnosis of chronic obstructive pulmonary disease are independently associated with AKI.Copyright © 2021 Elsevier Inc. All rights reserved.

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