Intravenous fenoldopam for early acute kidney injury after liver transplantation

Abstract

Acute kidney injury remains a serious complication after orthotopic liver transplantation. To date, several ‘renal-protective’ agents have been explored in this setting but with conflicting and disappointing results. Therefore, our aim is to evaluate the effects of fenoldopam in liver transplant patients with an established renal injury. In this prospective study, intravenous fenoldopam 0.1 µg/kg/min was administered to consecutive liver transplant patients with postoperative (within 7 days from surgery) stage 2 acute kidney injury (AKI) according to the Acute Kidney Injury Network classification. Actual glomerular filtration rate (GFR; calculated by the iohexol plasma clearance), serum creatinine (SCr) and cystatin C (SCyC) were used to assess the effect of the medication on the patients. During the study, 295 patients underwent liver transplant. Fifty-one patients (17.6 %) met the inclusion criteria and the data from 48 patients were analysed. SCr and SCyC levels decreased (p p p p We showed that fenoldopam was capable of improving some renal function parameters in postoperative liver transplantation patients with on-going AKI. This preliminary study now sets the stage for a multicenter, randomized, placebo-controlled trial in order to provide definite evidence.