Sevoflurane versus isoflurane: does it matter in renal transplantation?

Different inhalational anesthetics have various hemodynamic effects, either on the global circulation or on kidney perfusion. These drugs are also different concerning their potential for renal toxicity. The potential influence of the choice of the halogenated anesthetion in the outcome of kidney transplantation has not been previously studied, which was the purpose of this observational study.

We examined the hospital records and anesthesiology charts of 200 patients undergoing renal transplantation using general anesthesia. We divided these patients in two groups according to the inhalational anesthetic used during the kidney transplant: Isoflurane (n = 103) or sevoflurane (n = 97). The evaluated outcomes were creatinine values at 1, 3, and 6 months after transplantation, the start of diuresis (immediate, before the postoperative hour 4, or after hour 4), the need for postoperative dialysis and the incidence of graft rejection.

The groups were not different concerning age, gender, or weight. We did not observe significant differences in the postoperative creatinine levels: P = .44, P = .91, and P = .88, respectively, at 1, 3, or 6 months. The immediate start of diuresis (77.7% in the isoflurane group and 70.1% in the sevoflurane group; P = .14), the need for postoperative dialysis (8.7% vs. 13.4%; P = .37), and the incidence of rejection (4.9% vs 9.3%, P = .22) were similar.

Our study did not detect any effect of the choice of the inhalational anesthetic on the outcome of kidney transplantation.