Effects of the Type of Intraoperative Fluid in Living Donor Kidney Transplantation: A Single-Center Retrospective Cohort Study
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Purpose: Perioperative fluid management in kidney transplant recipients is crucial to supporting the fluid, acid-base, and electrolytebalance required for graft perfusion. However, the choice of intraoperative crystalloids in kidney transplantation remainscontroversial. We conducted a single-center retrospective cohort study to evaluate the impact of intraoperative fluids on acidbaseand electrolyte balance and graft outcomes. Materials and Methods: We included 282 living donor kidney transplant recipients from January 2010 to December 2017. Patientswere classified into two groups based on the type of intraoperative crystalloids used (157 patients in the half saline groupand 125 patients in the balanced crystalloid solutions group, Plasma-lyte). Results: Compared with the half saline group, the Plasma-lyte group showed less metabolic acidosis and hyponatremia duringsurgery. Hyperkalemia incidence was not significantly different between the two groups. Changes in postoperative graft functionassessed by blood urea nitrogen and creatinine were significantly different between the two groups. Patients in the Plasma-lytegroup exhibited consistently higher glomerular filtration rates than those in the half saline group at 1 month and 1 year after transplantationafter adjusting for demographic differences. Conclusion: Intraoperative Plasma-lyte can lead to more favorable results in terms of acid-base balance during kidney transplantation. Patients who received Plasma-lyte showed superior postoperative graft function at 1 month and 1 year after transplantation. Further studies are needed to evaluate the superiority of intraoperative Plasma-lyte over other types of crystalloids in relation tograft outcomes.
Abstract
Purpose: Perioperative fluid management in kidney transplant recipients is crucial to supporting the fluid, acid-base, and electrolytebalance required for graft perfusion. However, the choice of intraoperative crystalloids in kidney transplantation remainscontroversial. We conducted a single-center retrospective cohort study to evaluate the impact of intraoperative fluids on acidbaseand electrolyte balance and graft outcomes. Materials and Methods: We included 282 living donor kidney transplant recipients from January 2010 to December 2017. Patientswere classified into two groups based on the type of intraoperative crystalloids used (157 patients in the half saline groupand 125 patients in the balanced crystalloid solutions group, Plasma-lyte). Results: Compared with the half saline group, the Plasma-lyte group showed less metabolic acidosis and hyponatremia duringsurgery. Hyperkalemia incidence was not significantly different between the two groups. Changes in postoperative graft functionassessed by blood urea nitrogen and creatinine were significantly different between the two groups. Patients in the Plasma-lytegroup exhibited consistently higher glomerular filtration rates than those in the half saline group at 1 month and 1 year after transplantationafter adjusting for demographic differences. Conclusion: Intraoperative Plasma-lyte can lead to more favorable results in terms of acid-base balance during kidney transplantation. Patients who received Plasma-lyte showed superior postoperative graft function at 1 month and 1 year after transplantation. Further studies are needed to evaluate the superiority of intraoperative Plasma-lyte over other types of crystalloids in relation tograft outcomes.
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