Acute kidney injury (AKI) is one of the most frequent postoperative complications after
liver transplantation (LT). Increased serum
ammonia levels due to the
liver disease itself may affect postoperative renal function. This study aimed to compare the incidence of postoperative AKI according to preoperative serum
ammonia levels in patients after LT. Medical records from 436 patients who underwent LT from January 2010 to February 2020 in a single university hospital were retrospectively reviewed. The patients were then categorized according to changes in plasma
creatinine concentrations within 48 h of LT using the
Acute Kidney Injury Network criteria. A preoperative serum
ammonia level above 45 mg/dL was associated with postoperative AKI (p < 0.0001). Even in patients with a normal preoperative
creatinine level, when the
ammonia level was greater than 45 μg/dL, the incidence of postoperative AKI was significantly higher (p < 0.0001); the AKI stage was also higher in this group than in the group with preoperative
ammonia levels less than or equal to 45 μg/dL (p < 0.0001). Based on the results of our research, an elevation in preoperative serum
ammonia levels above 45 μg/dL is related to postoperative AKI after LT.