Related Experiment Video
Updated: Oct 1, 2025
08:12
Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation
Published on: July 15, 2015
19.3K
Crystalloid fluids and delayed graft function in kidney transplant: A cohort study
Amr ALKouny1, Mohammed K ALHarbi2, Abdulrahman R ALTheaby3
1Department of Anesthesia, King Abdul Aziz Medical City, Riyadh, Saudi Arabia.
Saudi Journal of Anaesthesia
|March 9, 2022
Summary
Fluid type and volume administered during kidney transplants did not significantly impact delayed graft function (DGF). Cold ischemia time was the main factor influencing DGF, not the crystalloid solution used.
Area of Science:
- Nephrology
- Transplantation Surgery
- Critical Care Medicine
Background:
- Normal saline, frequently used in kidney transplantation, carries a risk of hyperchloremic metabolic acidosis due to its high chloride content.
- Balanced electrolyte solutions with lower chloride content may offer an advantage.
- Limited evidence exists on optimal fluid management strategies during kidney transplantation and their impact on delayed graft function (DGF).
Purpose of the Study:
- To investigate the influence of intraoperative crystalloid fluid type and volume on the incidence of delayed graft function (DGF) after kidney transplantation.
- To identify factors independently associated with DGF in kidney transplant recipients.
Main Methods:
- A study included 138 kidney transplant patients, followed for seven days post-surgery.
- Crystalloid type (lactated Ringer's, normal saline, PlasmaLyte) and volume were compared between patients with and without DGF.
- Logistic regression analysis identified variables independently correlated with DGF, reporting odds ratios (OR) and 95% confidence intervals (CI).
Main Results:
- The incidence of DGF was 8.7%.
- Cold ischemia time was independently associated with increased odds of DGF (OR = 1.006).
- Intraoperative fluid type or volume did not significantly alter DGF odds. Patients receiving normal saline developed more intraoperative acidosis, but acid-base and electrolyte levels did not differ significantly between DGF and non-DGF groups.
Conclusions:
- Delayed graft function (DGF) in kidney transplantation is primarily influenced by surgical factors, notably cold ischemia time.
- Intraoperative fluid management, including crystalloid type and volume, did not demonstrate a significant impact on DGF incidence in this study.
- Further research may be needed to fully elucidate the role of fluid management in optimizing kidney transplant outcomes.
Related Concept Videos
01:28Kidney Transplant I: Introduction
68
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
68
01:26Kidney Transplant II: Surgical Procedure
82
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
82
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
69
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
69
01:16Kidney Transplant III: Nursing Management
90
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
90
01:29Acute Kidney Injury III: Clinical Manifestations
132
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
132
01:29Acute Kidney Injury II: Pathophysiology
136
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
136