Acute renal failure occurring immediately after liver transplantation and requiring hemodialysis is a major problem resulting in a poor prognosis.
Dr Nobuhisa Akamatsu and colleagues investigated the efficacy of human atrial natriuretic peptide.
Atrial natriuretic peptide has potent natriuretic and protective effects for glomeruli in preventing acute renal failure after liver transplantation.
The researchers included 37 patients who underwent live donor liver transplantation with model for end-stage liver disease scores greater than 15.
Subjects were prospectively randomized into 2 groups.
There were 19 patients in Group1 who received synthetic human atrial natriuretic peptide infusion.
|2 receiving atrial natriuretic peptide required hemodialysis after transplant vs 7 controls|
Group 2 included 18 patients who received conventional diuretics, furosemide and potassium canrenoate.
Peri- and postoperative changes in hemodynamic status and renal function were compared between the 2 groups.
The researchers found no statistical differences in the changes in hemodynamic status between groups.
The team noted that hemodialysis was required after liver transplantation in 9 patients, 2 in Group 1 and 7 in Group 2.
Postoperative creatinine clearance was higher in Group 1.
In addition, the researchers noted that aldosterone level was suppressed in Group 1.
Dr Akamatsu's team concludes, “Continuous infusion of synthetic human atrial natriuretic peptide might be effective for preventing acute renal failure requiring hemodialysis after liver transplantation.”