The relationship between preoperative creatinine clearance and early outcomes of adult patients undergoing deceased donor liver transplant

Introduction: Preoperative renal dysfunction is detected in many patients undergoing liver transplants (LTs), which is significant in determining the potential surgical outcome. Objectives: This study aimed to assess the renal dysfunction of the recipient before LT and its short-term impact after the surgery. Patients and Methods: We reviewed the records of eligible 148 consecutive adult LT recipients from deceased donors between March 2019 and November 2021. Liver re-transplant, combined kidney-liver transplants, pre-existing kidney transplant, and renal replacement therapy before transplant were excluded. Patients who underwent LTs were divided into two groups based on their pre-LT creatinine clearance as calculated by the Cockcroft-Gault formula; group I (creatinine clearance <70 mL/min) and group II (creatinine clearance >= 70 mL/min). Then, the relationship between pretransplant renal function and early LT outcomes, including 3- and 12-month survival, and selected post-transplant variables were assessed. Results: Of the 148 patients, 73 (49.3%) had preoperative creatinine clearance less than 70 mL/min. Warm ischemia time (min) was considerably higher in group II (P=0.048). However, group I had significantly delayed peak total bilirubin levels after surgery (P=0.03) as well as post-LT longer hospitalization (P<0.001) and more readmissions (P=0.002) compared to group II. No significant differences in 3- and 12-month survival rates were observed between the two groups (P=0.383 and P=0.766, respectively). Conclusion: Renal dysfunction before LT did not significantly influence short-term survival after the surgery but did negatively affect hospital stay and readmission post-transplant.