Barri et al evaluated various criteria for diagnosing acute kidney injury (AKI) in a patient following liver transplantation. Early detection of acute renal injury allows for an early intervention and hopefully an improved outcome. The authors are from the Baylor Regional Transplant Institute in Dallas.



(1) baseline pretransplant serum creatinine in mg/dL

(2) serum creatinine after the liver transplant in mg/dL


change in the serum creatinine =

= (serum creatinine after the transplant) - (baseline serum creatinine before the transplant)


percent increase in serum creatinine =

= (change in serum creatinine) / (baseline serum creatinine) * 100%




change in creatinine > 0.5 mg/dL

mild AKI

change in creatinine > 1.0 mg/dL

more severe AKI

percent increase > 50% AND serum creatinine after transplant > 2 mg/dL

more severe AKI



• A patient who met any of the criteria had reduced survival for both the patient and the liver graft..

• A patient who met the third criterion had the worst survival for both the patient and the liver graft (66% 5 year survival if met criterion; 76% if did not).


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