Document Detail

Acute renal failure after ligation of the hepatic artery.
MedLine Citation:
PMID:  959959     Owner:  NLM     Status:  MEDLINE    
Acute renal failure developed in nine of 78 patients who were subjected to hepatic artery ligation for nonresectable and extensive malignant tumor of the liver. Of those nine, six had hepatomas, one cholangiocarcinoma, one metastatic islet-cell carcinoma and one metastatic melanoma. Preoperative renal function as reflected in blood-urea-nitrogen and serum creatinine values was within normal limits. There were marked elevations of serum glutamic-oxalacetic transaminase and lactic dehydrogenase levels after hepatic artery ligation, an indication of massive ischemic injury of the tumor and the liver. A diagnosis of acute renal failure was established within 14 to 70 hours after hepatic artery ligation. In five patients, oliguric renal failure developed, and in four, high urinary output renal failure. In only three patients did systemic hypotension and hypovolemia precede acute renal failure. Seven of the nine patients died. Postmortem examination was done in five patients, and in only two was there evidence of renal tubular necrosis. The factors contributing to acute renal failure appear to be extensive involvement of the liver by tumor, presence of ascites and jaundice, occlusion of the portal vein and hyperuricemia. The presence of any one of the foregoing contraindicates the procedure.
D K Kim; R Penneman; B Kallum; M Carrillo; E Scheiner; J G Fortner
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Surgery, gynecology & obstetrics     Volume:  143     ISSN:  0039-6087     ISO Abbreviation:  Surg Gynecol Obstet     Publication Date:  1976 Sep 
Date Detail:
Created Date:  1976-10-29     Completed Date:  1976-10-29     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0101370     Medline TA:  Surg Gynecol Obstet     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  391-4     Citation Subset:  AIM; IM    
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MeSH Terms
Aspartate Aminotransferases / blood
Chemotherapy, Cancer, Regional Perfusion
Hepatic Artery / surgery*
Hyperkalemia / blood
Hypotension / etiology
Kidney Failure, Acute / enzymology,  etiology*
Kidney Function Tests
Kidney Tubular Necrosis, Acute / etiology
L-Lactate Dehydrogenase / blood
Liver Neoplasms / surgery
Middle Aged
Neoplasm Metastasis
Postoperative Complications / enzymology,  etiology*
Uric Acid / blood
Reg. No./Substance:
69-93-2/Uric Acid; EC Dehydrogenase; EC Aminotransferases

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