To observe the occurrence of early acute kidney injury (AKI) in patients after liver transplantation, in order to explore its risk factors and prognostic effects.

A retrospective analysis was made of the clinical data of patients who underwent liver transplantation at the Department of Liver Surgery, the First Affiliated Hospital of Nanjing Medical University from October 2015 to November 2017. The AKI diagnosis and staging criteria of Kidney Disease: Improving Global Outcomes (KDIGO) in 2012 were used to observe the occurrence of AKI after liver transplantation. The patients were divided into two groups according to the situation of AKI: AKI group and non-AKI group. The risk factors of AKI after operation were analyzed by logistic regression method. Kaplan-Meier survival curve was used to analyze the prognosis of patients of 30 days, 90 days, and 1 year after operation.

A total of 146 patients undergoing liver transplantation were observed, among whom 67 patients presented AKI (45.9%), including AKI stage I (70.1%), stage II (22.4%), and stage Ⅲ (7.5%), and renal replacement therapy (RRT) treatment in 7 patients (10.4%). The 30 day and 90 day survival rates of patients with AKI stage Ⅱ-Ⅲ were significantly lower than those of patients with non-AKI and patients with AKI stage I. Multivariate logistic regression analysis showed that preoperative serum creatinine and international normalized ratio (INR), peak postoperative serum aspartate aminotransferase (AST), and hemoglobin were independent risk factors. And the severity of hepatic ischemia-reperfusion injury (HIRI) based on peak AST was associated with the occurrence of AKI.

The incidence of AKI was high after liver transplantation, which was related to short-term prognosis of the patients. Paying attention to the risk factors of AKI after liver transplantation will help to take further active and effective intervention measures, being of great significance for improving the prognosis of patients after liver transplantation.