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Vancomycin-induced acute kidney injury after liver transplantation |
Xiao-Ping Shi a , # , Dong-Hui Lao a , # , Qing Xu a , # , Min Zhang b , Yun-Hong Lu a , Yu Gong c , Ting Wang c , ∗ |
a Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai 200032, China
b Department of Pharmacy Services, Boston Medical Center, Boston, MA 02118, USA
c Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
∗ Corresponding author.
E-mail address: drwangting@163.com (T. Wang).
# Contributed equally. |
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Abstract Multidrug-resistant Gram-positive bacteria Staphylococcus aureus and Enterococcus species emerge as major pathogens after liver transplantation (LT). Although vancomycin remains the best choice of drug for treating those infections, it is associated with significant nephrotoxicity. Acute kidney injury (AKI) is a common complication in liver recipients due to a combination of factors related to the recipient, donor graft, intraoperative and posttransplant events. At present, no liver recipients have been enrolled in any study evaluating the nephrotoxicity of vancomycin. It remains mostly unexplored whether the special pathophysiological state during the perioperative period along with the concurrent use of nephrotoxic agents, affects vancomycin-induced AKI (VI-AKI). Moreover, the relationship between the initial trough concentration and the incidence of nephrotoxicity in liver recipients is uncertain. Therefore, it is necessary to explore the relationship between the initial vancomycin trough concentration and the incidence of nephrotoxicity in LT patients and analyze the extent to which the use of concurrent nephrotoxic medications contributes to VI-AKI.
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