Kidney Week

Abstract: SA-PO1217

Complicated Liver Retransplantation Recipients Undergoing Intraoperative Kidney Replacement Therapy with Sustained Low-Efficiency Dialysis (SLED)

Session Information

• Transplantation: Clinical - Complications, Pediatrics, and Multi-Organ Considerations
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Wantoch-Rekowski, Filip, Uniwersyteckie Centrum Kliniczne Warszawskiego Uniwersytetu Medycznego Centralny Szpital Kliniczny, Warsaw, Poland

Filip Wantoch-Rekowski, MD

• Rymarz, Aleksandra, Uniwersyteckie Centrum Kliniczne Warszawskiego Uniwersytetu Medycznego Centralny Szpital Kliniczny, Warsaw, Poland

Aleksandra Rymarz, MD, PhD

• Zebrowski, Pawel, Uniwersyteckie Centrum Kliniczne Warszawskiego Uniwersytetu Medycznego Centralny Szpital Kliniczny, Warsaw, Poland

Pawel Zebrowski, MD, PhD

• Figiel, Wojciech, Uniwersyteckie Centrum Kliniczne Warszawskiego Uniwersytetu Medycznego Centralny Szpital Kliniczny, Warsaw, Poland

Wojciech Figiel, MD, PhD, ScD

• Grat, Michal, Uniwersyteckie Centrum Kliniczne Warszawskiego Uniwersytetu Medycznego Centralny Szpital Kliniczny, Warsaw, Poland

Michal Grat, MD, PhD, ScD

• Malyszko, Jolanta, Uniwersyteckie Centrum Kliniczne Warszawskiego Uniwersytetu Medycznego Centralny Szpital Kliniczny, Warsaw, Poland

Jolanta Malyszko, MD, PhD, FASN

Background

Compared with primary liver transplantation, liver retransplantation is more technically complex and associated with greater hemodynamic instability and metabolic derangements making intraoperative kidney replacement therapy (ioKRT) a potentially valuable supportive strategy in patients with kidney dysfunction.

Methods

The retrospective analysis of ioKRT during liver retransplantations (reLTx) performed in the University Hospital in 2023-2025. All ioKRTs were conducted using slow low-efficiency dialysis (SLED) with the Genius single-pass batch dialysis system. Instead of anticoagulation, regular flushes of 100 mL saline every 30 to 60 minutes were used.

Results

Among 768 patients who received LTX from 01.01.2023-06.30.2025, 99 (12.89%) required ioKRT, and 35 (4.56%) underwent retransplantation. For 22 patients (62.86%), retransplantation was a second transplantation procedure during the same hospitalization. 23 out of 35 patients (65.71%) required kidney replacement therapy (KRT) before reLTx, whereas 32 (91.42%) required continuation of RRT after the operation. No significant adverse effects associated with ioKRT were observed.

Conclusion

Intraoperative SLED provides effective metabolic and hemodynamic control during liver retransplantation and represents a valuable supportive strategy in this complicated and high-risk population.