• Ambica Parmar, David Bigam, Glenda Meeberg, Dominic Cave, Derek R Townsend, R T Noel Gibney, and Sean M Bagshaw.
• Division of Critical Care Medicine, University of Alberta, Edmonton, AB, Canada.
• Blood Purif. 2011 Jan 1; 32 (3): 238-48.

BackgroundIntraoperative continuous renal replacement therapy (CRRT) has been utilized during liver transplantation (LT). Our objective was to assess intraoperative CRRT for metabolic control, postoperative complications and outcomes.MethodsRetrospective matched cohort study. Cases were LT patients receiving intraoperative CRRT. Controls were matched for demographics and Model for End-Stage Liver Disease (MELD) score. Data were extracted on physiology, course and outcomes.Results72 patients were included. Despite effort to match by MELD, cases had higher scores (35.4 vs. 29.9, p = 0.01) compared to controls. Preoperatively, cases received more vasopressors (p = 0.006), and more RRT (94.4 vs. 25.7%, p < 0.0001). There was no difference in complications (p = 0.35) or ICU re-admission rate (p = 0.29). Cases were more likely to require postoperative RRT (p < 0.0001). There was no difference in hospital mortality (p = 0.61).ConclusionsLT patients selected for intraoperative CRRT more commonly have hemodynamic instability and preoperative acute kidney injury requiring RRT. Despite higher illness severity for cases, there were no differences in complications or mortality.Copyright © 2011 S. Karger AG, Basel.

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