Figure 4.

Diagnostic algorithm of patient selection. A total of 70 patients (29 men and 41 women; age, >18 years) who underwent living donor liver transplantation at Kyushu University Hospital between July 2016 and March 2018 were enrolled in the study after obtaining written informed consent. Patients with renal impairment due to septic ischemia, antibiotics, hepatorenal syndrome, or other causes and patients who had received renal replacement therapy were excluded. Additionally excluded were patients with renal impairment despite low tacrolimus levels, patients whose SCr levels were unaffected by changes in the tacrolimus dosage, patients with perioperative renal impairment before postoperative tacrolimus-based immunosuppression treatment, and patients with a preoperative eGFR (<60 mL/min/1.73 m²) or diabetes mellitus. Ultimately, 20 patients without AKI (control) and 6 patients with tacrolimus-induced AKI were included in the analysis. AKI, acute kidney injury; eGFR, estimated glomerular filtration rate; KDIGO, Kidney Disease Improving Global Outcomes; SCr, serum creatinine.