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    P.353: Impact factors leading to renal impairment after liver transplantation: a single center consecutive 12 years’ experience.
    (Wolters Kluwer, 2024-09-01) ; ;
    Chuluunbileg Batbold
    ;
    Fidel López‐Verdugo
    ;
    Jade M. Nunez
    Introduction: Renal impairment (RI) is a common life-threatening complication of cirrhosis, affecting one in every five patients. Although LT is a lifeline for cirrhotic patients with impaired renal function, postoperative acute RI is not uncommon and is influenced by multiple factors, leading to poor outcomes. Hepatitis B virus (HBV) infection has been associated with increased risk of developing chronic kidney disease in some studies. The potential role of HBV infection in post-LT RI is unknown. This is likely due to the low prevalence of HBV infection amongst liver transplant recipients, which has been reported to be around 5% in the USA. Low- and Middle income country like Mongolia has the highest rate of hepatocellular carcinoma and hepatitis B in the world. Mongolian First liver transplant (LT) performed at First Central Hospital of Mongolia (FCHM) in September 2011 in a collaborative effort with South Korea’s Asan Medical Center. In this context, the aim of our study is identify the role of HBV infection on the incidence of renal impairment after liver transplantation. We hypothesize that patients with HBV infection will have a higher rate of RI post-LT. Methods: To determine the changes of renal function of peri- and post-LT as well as to identify risk factors for RI, we analyzed the First Central Hospital of Mongolia (FCHM) Liver Transplantation Database retrospectively, which includes patients who received LT between September 21, 2011, and December 31, 2022. Early RI was identified by measuring glomerular filtration rates by Cockcroft-Gault creatinine clearance formulation at pretransplantation, intraoperatively, 24h, 72h, 7d, 14d and 28d post LT. Results: The results revealed that female gender (OR=3.06; 95% CI=1.58–5.91), Child-Tucotte-Pugh (CTP) score B and C (OR=4.23; 95% CI=0.92–19.41), (OR=7.68; 95% CI=1.67–35.30), preoperative continuous renal replacement therapy (CRRT) (OR=5.86; 95% CI=1.1–31.21), high graft to recipient weight ratio (GRWR) (OR=3.45; 95% CI=1.23–9.63) increased the risk of RI among recipients. Moreover, recipients’ age (OR=1.07; 95% CI=1.03–1.11), Model for End-Stage Liver Disease (MELD) score (OR=1.09; 95% CI=1.03–1.16), intraoperative leukoreduced red blood cells (LR-RBC) (OR=1.09; 95% CI=1.04–1.14), platelet (PLT) (OR=1.06; 95% CI=1.00–1.12+), fresh frozen plasma (FFP) (OR=1.07; 95% CI=1.02–1.11) and postoperative LR-RBC (OR=1.09; 95% CI=1.04–1.14), cryoprecipitate transfusion (OR=1.1; 95% CI=1.01–1.19), intubated hours (OR=1.04; 95% CI=1.01–1.07) increased slightly the risk of RI. Conclusions: Female gender, high Child Pugh score, preoperative CRRT and high graft to recipient weight ratio are the primary risk factors RI after liver transplant surgery in Mongolia. The liver transplantation team at the FCHM expresses our gratitude to Prof. Sung-Gyu Lee and Liver transplantation team from the Asan Medical Center, Seoul, South Korea. Their contribution was invaluable in the form of guidance and precious knowledge transfer for developing the robust liver transplantation program in Mongolia.
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    Impact factors leading to renal impairment after liver transplant surgery: a single center study
    (2022-11-14) ; ; ;
    Fidel López‐Verdugo
    ;
    Batsaikhan Batsuuri, Shiirevnyam Avirmed, Bat-Ireedui Badarch, Fidel Lopez-Verdugo, Ariunaa Togtokh, Shiirevnyam Avirmed, Sergelen Orgoi. Korean J Transplant 2022;36:195. https://doi.org/10.4285/ATW2022.F-3297
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    Study of risk factors for anastomosis and non-anastomosis biliary strictures after liver transplantation
    (2022-11-14)
    Undarmaa Zandanbazar
    ;
    ;
    BatIreedui Batdarch
    ;
    ;
    Background: In Mongolia 2020, there are 1,414 respiratory diseases, 1,833 gastrointestinal diseases, 1,268 cardiovascular diseases, 1,084 urogenital diseases, 598 injuries, poisonings and other external diseases per 10,000 population in our country, and compared to 2019, the leading causes of diseases are decreased by 12,685. As of 2020, there were 353 cases of acute hepatitis virus infection nationwide, which is 1.1 per 10,000 population, which is 1.1% of the total infectious diseases. Compared to last year, the number of reported cases decreased by 174 cases or 0.6 per 10,000 population. Methods: The survey will be conducted among 155 clients who underwent liver transplant surgery between March 2011 and April 2022, based on the Organ Transplant Center of the Ulaanbaatar City Hospital, with the approval of the Ethics Committee. Results: Regardless of the type of grafts or biliary reconstruction, the overall incidence of BC's in recipients ranges from 7.4% to 25%; leaks occur in 5%-18%, Pand strictures occur in 6%-20%. Conclusions: Anastomosis and non-anastomosis stenosis after liver transplant surgery are affected by the duration of warm and cold ischemic time, stenosis and occlusion of the hepatic artery.
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    Risk Factors of Delayed Graft Function in Patients with Kidney Transplantation
    (Mongolian National University of Medical Sciences, 2025-09-30)
    Oyunpurev Erdenechimeg
    ;
    Tuvshinbayar Javzan
    ;
    Uugan-Erdene Amarbold
    ;
    Od-Erdene Lkhaakhuu
    ;
    Kishgee Tseren
    Objective: In Mongolia, since 2006, kidney transplantation has been performed regularly, with more than 400 people having undergone this surgery. This preliminary study aimed to investigate the incidence of delayed graft function after kidney transplantation in Mongolia and to identify the associated risk factors. Methods: This study used a retrospective approach, gathering data from monitoring records. We applied the Student t-test, one-way ANOVA, Wilcoxon rank sum test, Kruskal-Wallis rank test, Spearman correlation, multivariate linear regression, and logistic regression. Results: Of the 268 recipients, 198(74.44%) were male. There were 14 total cases of DGF, of which 13 were transplanted from brain-dead donors. Postoperative urine outcome decreases by 120 mL for a 1-year increase in donor age (b = -120, p= 0.033). A 1-minute increase in cold ischemia time results in a 20-mL decrease in urine output (b = -20, p= 0.002). Donor age>40 increased the risk by 1.2 times (OR=1.2, p= 0.05), and brain-dead donor increased the risk by 19.37 times (OR=19.37, p= 0.0001), while recipient age<35 reduced the risk by 5 times (OR=0.2, p= 0.039). Conclusion: Our study found that risk factors such as older donor and recipient age, prolonged cold and warm ischemia times, and brain-dead donor status were associated with an increased risk of delayed graft function.