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Abstract: FR-PO020

AKI After Lung Transplantation: A Meta-Analysis

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Thongprayoon, Charat, Mayo Clinic, Rochester, Minnesota, United States
  • Lertjitbanjong, Ploypin, Bassett medical center, Cooperstown, New York, United States
  • Kaewput, Wisit, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Mao, Michael A., Mayo Clinic, Rochester, Minnesota, United States
  • Cheungpasitporn, Wisit, university of mississippi Medical Center, Jackson, Mississippi, United States
Background

Lung transplantation has been increasingly performed worldwide and considered as an effective therapy for patients with various end-stage lung diseases. We performed this meta-analysis to evaluate the incidence and impact of acute kidney injury (AKI) in patients after lung transplantation

Methods

A literature search was conducted utilizing MEDLINE, EMBASE and Cochrane Database from inception through April 2019. We included studies that evaluated the incidence of AKI, severe AKI requiring renal replacement therapy (RRT), and impact of AKI among patients after lung transplantation. Pooled incidence and odds ratios (OR) with 95% confidence interval (CI) were calculated using random effects meta-analysis.

Results

25 cohort studies with a total of 40,293 patients after lung transplantation were enrolled. Overall, the pooled estimated incidence rates of AKI (by standard AKI definitions) and severe AKI requiring RRT following lung transplantation were 52.1% (95%CI: 45.0%-59.1%) and 9.5% (95%CI: 7.7%-11.8%). Meta-regression analysis showed that year of study did not significantly affect the incidence of AKI (p=0.11) and severe AKI requiring RRT (p=0.54). The pooled OR of hospital mortality among patients after lung transplantation with AKI and severe AKI requiring RRT were 2.75 (95% CI, 1.18-6.41) and 10.89 (95% CI, 5.03-23.58). At 5 year, the pooled OR of mortality among patients after lung transplantation with AKI and severe AKI requiring RRT were 1.47 (95% CI, 1.11-1.94) and 4.79 (95% CI, 3.58-6.40), respectively.

Conclusion

The overall estimated incidence rates of AKI and severe AKI requiring RRT in patients after lung transplantation are 52% and 9.5%, respectively. Despite advance in medicine, incidence of AKI in patients after lung transplantation does not seem to decrease over time. In addition, AKI after lung transplantation is significantly associated with reduced short-term and long-term survival.