Zhang D, Sun J, Xu CS, Yang ZZ, Wu XD, Zhao K, Cai JZ, Wang JH. Role of sonographic hepatorenal index and renal resistive index in monitoring of acute kidney injury after liver transplantation. World J Radiol 2025; 17(6): 105962 [DOI: 10.4329/wjr.v17.i6.105962]
Corresponding Author of This Article
Jian-Hong Wang, MD, Doctor, Organ Transplantation Center, The Affiliated Hospital of Qingdao University, Zhonghan Street, Laoshan District, Qingdao 266100, Shandong Province, China. ningtai@sina.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Jun 28, 2025; 17(6): 105962 Published online Jun 28, 2025. doi: 10.4329/wjr.v17.i6.105962
Role of sonographic hepatorenal index and renal resistive index in monitoring of acute kidney injury after liver transplantation
Di Zhang, Jiao Sun, Chuan-Shen Xu, Zi-Zhen Yang, Xiao-Dong Wu, Kai Zhao, Jin-Zhen Cai, Jian-Hong Wang
Di Zhang, Jiao Sun, Chuan-Shen Xu, Zi-Zhen Yang, Xiao-Dong Wu, Kai Zhao, Jin-Zhen Cai, Jian-Hong Wang, Organ Transplantation Center, The Affiliated Hospital of Qingdao University, Qingdao 266100, Shandong Province, China
Author contributions: Zhang D and Sun J designed and performed the research and wrote the paper; Xu CS and Yang ZZ designed the research and contributed to the analysis; Wu XD and Zhao K made critical revisions related to important intellectual content of the manuscript; Cai JZ and Wang JH designed the research and provided the final approval of the version of the article to be published.
Supported by the Clinical + X Scientific Research Project of Affiliated Hospital of Qingdao University, No. QYFY + X202101060; and Natural Science Foundation of Shandong Province, No. ZR2023MH240.
Institutional review board statement: This study was reviewed and approved by The Affiliated Hospital of Qingdao University’s Ethics Committee (No. QYFY WZLL 27926).
Informed consent statement: Signed informed consent forms were provided by all patients.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Hong Wang, MD, Doctor, Organ Transplantation Center, The Affiliated Hospital of Qingdao University, Zhonghan Street, Laoshan District, Qingdao 266100, Shandong Province, China. ningtai@sina.com
Received: February 13, 2025 Revised: April 12, 2025 Accepted: May 21, 2025 Published online: June 28, 2025 Processing time: 134 Days and 21.5 Hours
Abstract
BACKGROUND
Acute kidney injury (AKI) is a frequent complication after liver transplantation (LT). How to realize the early diagnosis of AKI, perform active intervention, and reduce the mortality of post-LT patients is an urgent problem to be solved.
AIM
To investigate the accuracy of hepatorenal index (HRI) and renal resistive index (RRI) in monitoring of early AKI after LT.
METHODS
This observational study included adult deceased-donor LT recipients at our center between February 2022 and February 2023 with no preoperative renal dysfunction. The HRI and RRI were recorded once per day in the postoperative period through to postoperative day (POD) 7. We followed up with the patients at 1 month after LT. The patients were divided into the AKI and non-AKI groups according to the Kidney Disease Improving Global Outcomes criteria.
RESULTS
Of 121 patients were included in the study (mean age: 50.18 ± 8.88years; female: 17.36%). AKI developed in 53 patients (43.80%). The AKI and non-AKI groups were similar in terms of their baseline characteristics. An HRI of ≤ 1.12 on POD 1 detected AKI with a sensitivity of 62.30% and a specificity of 87.80% [area under the receiver operating characteristic curve (AUC) = 0.801, P < 0.01]. An RRI of ≥ 0.65 on POD 1 detected AKI with a sensitivity of 87.80% and a specificity of 67.60% (AUC = 0.825, P < 0.01). The HRI combined with the RRI was more effective at detecting AKI than either the HRI or RRI alone (AUC = 0.890, P < 0.01). The HRI increased as AKI resolved while the RRI decreased as AKI resolved.
CONCLUSION
The HRI and RRI are non-invasive bedside indices that can identify the occurrence and recovery of early AKI after LT.
Core Tip: In this observational study, we examined the monitoring value of the hepatorenal index and renal resistive index for acute kidney injury in deceased-donor liver transplantation recipients. We conclude that the hepatorenal index and renal resistive index are non-invasive bedside indices that can identify the occurrence and recovery of acute kidney injury, which aids in the intervention and adjustment of treatment plans, thereby improving the prognosis of patients with acute kidney injury after liver transplantation.
