Efecto de la albúmina humana intraoperatoria sobre la función temprana del injerto en transplante renal
Effect of intraoperative human albumin on early graft function in renal transplantation
Shah RB, Shah VR, Butala BP, Parikh GP.
Saudi J Kidney Dis Transpl [serial online] 2014 [cited 2014 Nov 10];25:1148-53.
Abstract
Adequate intravascular volume maintenance is essential to ensure early graft function during renal transplantation. Various recommendations on optimum fluid therapy are based, at best, on sparse evidence, and that too only from observational studies. This prospective randomized controlled study was done to evaluate the effect of 20% human albumin on the early graft function in living donor renal transplantation. Eighty patients undergoing renal transplantation were randomly assigned to one of the intraoperative fluid regimens, 0.9% normal saline with 20% human albumin (albumin group) or 0.9% normal saline alone (saline group), after confirming the exclusion criteria. Intravenous fluid infusion was given to keep central venous pressure (CVP) between 12 to 15 mm Hg. The statistical package of social sciences, SPSS version 12, was used for statistical analysis. The intraoperative fluid volume infused [albumin group - 3381 ± 1021.2 vs. saline group - 3487 ± 978.5 (mL)] to maintain target CVP was comparable between the two groups (P value >0.05). Statistically, no significant difference was found between the two groups in terms of post transplant serum creatinine [day one; 2.76 ± 1.0 vs. 2.58 ± 0.94, day three; 1.48 ± 0.53 vs. 1.43 ± 0.71, day seven; 1.42 ± 0.6 vs. 1.42 ± 0.53 (mg/dL)] and urine output [day one; 13122.5 ± 5767.8 vs. 13909.4 ± 5324.7, day three; 9233.9 ± 3267.4 vs. 9250 ± 4794.2, day seven; 7517.6 ± 3043.6 vs. 6921.4 ± 3170 (mL)] (P value >0.05). Postoperative change in body weight [1.89 ± 3.82 vs. 2.48 ± 3.89 (kg)], tissue edema (10% vs. 7.5%), and pulmonary edema (2.5% vs. 5%) did not differ significantly (P >0.05). Twenty percent human albumin given intraoperatively, as a volume expander, does not improve early graft function in living donor renal transplantation. It should be used selectively rather than as a routine protocol.
http://www.sjkdt.org/text.asp?2014/25/6/1148/144246
El efecto de la administración de manitol al donante de riñón en los resultados a corto plazo del trasplante de riñón.
The effect of mannitol administration to kidney donor on short-term outcomes of kidney transplantation.
Esfahani HS, Nooraei N, Asgary M, Hashemian MR.
Saudi J Kidney Dis Transpl [serial online] 2014 [cited 2014 Nov 10];25:1154-9.
Abstract
As the cases of kidney transplant are increasing, the need to apply the factors to increase the success of transplant seems necessary. Mannitol increases the osmotic pressure and urine volume as a protective agent on renal tubules. We aimed to evaluate the effect of mannitol on short-term outcome of kidney transplantation by comparing two groups based on prescribing mannitol to donors. In a randomized clinical trial, 60 kidney recipients were assigned in two groups (30 in each), except that in one group donors received mannitol. They were studied with respect to age, gender, weight, blood urea nitrogen (BUN), creatinine (Cr), sodium (Na), potassium (K) and arterial blood gas (ABG) before and after surgery, and their pulse rate (PR) and blood pressure (BP) before, during and after surgery. Their urine volume was assessed in the operation room and the first 24 h after surgery. The short-term outcome, including BUN and Cr in the first 10 days after transplant, have been charted. Both the case (mannitol-positive donor patient) and the control (mannitol negative) groups were the same regarding the results gained for pre- and post-operative parameters. Follow-up assessments showed no significant differences in renal function. Based on this, we conclude that mannitol administration to donors does not have a beneficial effect on the prognosis and short-term outcome of transplantation on recipients; therefore, we feel that it should not be advised for kidney donors.
http://www.sjkdt.org/text.asp?2014/25/6/1154/144247
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Effect of intraoperative human albumin on early graft function in renal transplantation
Shah RB, Shah VR, Butala BP, Parikh GP.
Saudi J Kidney Dis Transpl [serial online] 2014 [cited 2014 Nov 10];25:1148-53.
Abstract
Adequate intravascular volume maintenance is essential to ensure early graft function during renal transplantation. Various recommendations on optimum fluid therapy are based, at best, on sparse evidence, and that too only from observational studies. This prospective randomized controlled study was done to evaluate the effect of 20% human albumin on the early graft function in living donor renal transplantation. Eighty patients undergoing renal transplantation were randomly assigned to one of the intraoperative fluid regimens, 0.9% normal saline with 20% human albumin (albumin group) or 0.9% normal saline alone (saline group), after confirming the exclusion criteria. Intravenous fluid infusion was given to keep central venous pressure (CVP) between 12 to 15 mm Hg. The statistical package of social sciences, SPSS version 12, was used for statistical analysis. The intraoperative fluid volume infused [albumin group - 3381 ± 1021.2 vs. saline group - 3487 ± 978.5 (mL)] to maintain target CVP was comparable between the two groups (P value >0.05). Statistically, no significant difference was found between the two groups in terms of post transplant serum creatinine [day one; 2.76 ± 1.0 vs. 2.58 ± 0.94, day three; 1.48 ± 0.53 vs. 1.43 ± 0.71, day seven; 1.42 ± 0.6 vs. 1.42 ± 0.53 (mg/dL)] and urine output [day one; 13122.5 ± 5767.8 vs. 13909.4 ± 5324.7, day three; 9233.9 ± 3267.4 vs. 9250 ± 4794.2, day seven; 7517.6 ± 3043.6 vs. 6921.4 ± 3170 (mL)] (P value >0.05). Postoperative change in body weight [1.89 ± 3.82 vs. 2.48 ± 3.89 (kg)], tissue edema (10% vs. 7.5%), and pulmonary edema (2.5% vs. 5%) did not differ significantly (P >0.05). Twenty percent human albumin given intraoperatively, as a volume expander, does not improve early graft function in living donor renal transplantation. It should be used selectively rather than as a routine protocol.
http://www.sjkdt.org/text.asp?2014/25/6/1148/144246
El efecto de la administración de manitol al donante de riñón en los resultados a corto plazo del trasplante de riñón.
The effect of mannitol administration to kidney donor on short-term outcomes of kidney transplantation.
Esfahani HS, Nooraei N, Asgary M, Hashemian MR.
Saudi J Kidney Dis Transpl [serial online] 2014 [cited 2014 Nov 10];25:1154-9.
Abstract
As the cases of kidney transplant are increasing, the need to apply the factors to increase the success of transplant seems necessary. Mannitol increases the osmotic pressure and urine volume as a protective agent on renal tubules. We aimed to evaluate the effect of mannitol on short-term outcome of kidney transplantation by comparing two groups based on prescribing mannitol to donors. In a randomized clinical trial, 60 kidney recipients were assigned in two groups (30 in each), except that in one group donors received mannitol. They were studied with respect to age, gender, weight, blood urea nitrogen (BUN), creatinine (Cr), sodium (Na), potassium (K) and arterial blood gas (ABG) before and after surgery, and their pulse rate (PR) and blood pressure (BP) before, during and after surgery. Their urine volume was assessed in the operation room and the first 24 h after surgery. The short-term outcome, including BUN and Cr in the first 10 days after transplant, have been charted. Both the case (mannitol-positive donor patient) and the control (mannitol negative) groups were the same regarding the results gained for pre- and post-operative parameters. Follow-up assessments showed no significant differences in renal function. Based on this, we conclude that mannitol administration to donors does not have a beneficial effect on the prognosis and short-term outcome of transplantation on recipients; therefore, we feel that it should not be advised for kidney donors.
http://www.sjkdt.org/text.asp?2014/25/6/1154/144247
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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