Evidence map›Paper›PMID 28395663›Full record

Trial reportCritical care (London, England)2017

Renal function and oxygenation are impaired early after liver transplantation despite hyperdynamic systemic circulation.

Jenny Skytte Larsson, Gudrun Bragadottir, Bengt Redfors, Sven-Erik Ricksten

Registry-linked trialOpen access · goldAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Critical care (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02455115 (Renal Perfusion, Filtration and Oxygenation After Liver Transplantation -Effects of av Postoperative Blood Pressure), which is not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.3field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02455115 nacompletednot on this map

Renal Perfusion, Filtration and Oxygenation After Liver Transplantation -Effects of av Postoperative Blood Pressure

TypeinterventionalSponsorSahlgrenska University HospitalRan2015 to 2016Enrolled12ConditionsAcute Kidney Injury, Liver FailureArmsAlternating mean arterial pressure, Norepinephrine, Chromium ethylenediaminetetraacetic acid
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 23 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Jenny Skytte LarssonDepartment of Anesthesiology and Intensive Care Medicine, Institution of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Blå Stråket 5, plan 5, 413 45, Gothenburg, Sweden. jenny.skytte@vgregion.se.
Gudrun BragadottirDepartment of Anesthesiology and Intensive Care Medicine, Institution of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Blå Stråket 5, plan 5, 413 45, Gothenburg, Sweden.
Bengt RedforsDepartment of Anesthesiology and Intensive Care Medicine, Institution of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Blå Stråket 5, plan 5, 413 45, Gothenburg, Sweden.
Sven-Erik RickstenDepartment of Anesthesiology and Intensive Care Medicine, Institution of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Blå Stråket 5, plan 5, 413 45, Gothenburg, Sweden.
Sahlgrenska University Hospital · SEUniversity of Gothenburg · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute kidney injury (AKI) occurs frequently after liver transplantation and is associated with the development of chronic kidney disease and increased mortality. There is a lack of data on renal blood flow (RBF), oxygen consumption, glomerular filtration rate (GFR) and renal oxygenation, i.e. the renal oxygen supply/demand relationship, early after liver transplantation. Increased insight into the renal pathophysiology after liver transplantation is needed to improve the prevention and treatment of postoperative AKI. We have therefore studied renal hemodynamics, function and oxygenation early after liver transplantation in humans.

methodsSystemic hemodynamic and renal variables were measured during two 30-min periods in liver transplant recipients (n = 12) and post-cardiac surgery patients (controls, n = 73). RBF and GFR were measured by the renal vein retrograde thermodilution technique and by renal extraction of Cr-EDTA (= filtration fraction), respectively. Renal oxygenation was estimated from the renal oxygen extraction.

resultsIn the liver transplant group, GFR decreased by 40% (p < 0.05), compared to the preoperative value. Cardiac index and systemic vascular resistance index were 65% higher (p < 0.001) and 36% lower (p < 0.001), respectively, in the liver transplant recipients compared to the control group. GFR was 27% (p < 0.05) and filtration fraction 40% (p < 0.01) lower in the liver transplant group. Renal vascular resistance was 15% lower (p < 0.05) and RBF was 18% higher (p < 0.05) in liver transplant recipients, but the ratio between RBF and cardiac index was 27% lower (p < 0.001) among the liver-transplanted patients compared to the control group. Renal oxygen consumption and extraction were both higher in the liver transplants, 44% (p < 0.01) and 24% (p < 0.05) respectively.

conclusionsDespite the hyperdynamic systemic circulation and renal vasodilation, there is a severe decline in renal function directly after liver transplantation. This decline is accompanied by an impaired renal oxygenation, as the pronounced elevation of renal oxygen consumption is not met by a proportional increase in renal oxygen delivery. This information may provide new insights into renal pathophysiology as a basis for future strategies to prevent/treat AKI after liver transplantation.

trial registrationClinicalTrials.gov, NCT02455115 . Registered on 23 April 2015.

Indexed as

Acute Kidney InjuryAgedFemaleGlomerular Filtration RateHemodynamicsHumansKidneyLinear ModelsLiver TransplantationMaleMiddle AgedOxygen ConsumptionRenal CirculationStatistics, NonparametricVascular ResistanceAcute kidney injuryGlomerular filtration rateLiver transplantationRenal blood flowRenal oxygenationRenal oxygen consumption

Identifiers

PMID28395663
PMCPMC5387193
OpenAlexW2605950455

What Socratic holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.