Central venous pressure monitoring in living donor kidney recipients does not affect immediate graft function: A propensity score analysis

Adelmann, Dieter; Bicknell, Leonie; Niemann, Claus U.; Feiner, John; Roll, Garrett R.; Burdine, Lyle; Whitlock, Elizabeth L.

doi:10.1111/ctr.13238

Cited by 8 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent study found that CVP does not correlate well with patients’ fluid status neither in general nor during kidney transplantation. 24 Its value as independent risk factor for DGF appears questionable not least because inconsistent results on the ideal range of intraoperative CVP for kidney transplantation were reported. 9,14 Therefore, we focused on the arterial blood pressure as the most frequently used surrogate parameter for organ perfusion.…”

Section: Discussionmentioning

confidence: 99%

Modifiable Risk Factors for Delayed Graft Function After Deceased Donor Kidney Transplantation

et al. 2019

View full text Add to dashboard Cite

Purpose: Delayed graft function is a major complication after kidney transplantation affecting patients’ long-term outcome. The aim of this study was to identify modifiable risk factors for delayed graft function after deceased donor kidney transplantation. Methods: This is a single-center retrospective cohort study of a university transplantation center. Univariate and multivariate step-wise logistic regression analysis of patient-specific and procedural risk factors were conducted. Results: We analyzed 380 deceased donor kidney transplantation patients between October 30, 2008 and December 30, 2017. The incidence of delayed graft function was 15% (58/380). Among the patient-specific risk factors recipient diabetes (2.8 [1.4-5.9] odds ratio [OR] [95% confidence interval [CI]]), American Society of Anesthesiologist score of 4 (2.7 [1.2-6.5] OR [95% CI]), cold ischemic time >13 hours (2.8 [1.5-5.3] OR [95% CI]) and donor age >55 years (1.9 [1.01-3.6] OR [95% CI]) revealed significance. The significant intraoperative, procedural risk factors included the use of colloids (3.9 [1.4-11.3] OR [95% CI]), albumin (3.0 [1.2-7.5] OR [95% CI]), crystalloids >3000 mL (3.1 [1.2-7.5] OR [95% CI]) and mean arterial pressure <80 mm Hg at the time of reperfusion (2.4 [1.2-4.8] OR [95% CI]). Conclusion: Patients undergoing deceased donor kidney transplantation with a mean arterial pressure >80 mm Hg at the time of transplant reperfusion without requiring excessive fluid therapy in terms of colloids, albumin or crystalloids >3000 mL are less likely to develop delayed graft function.

show abstract

Section: Discussionmentioning

confidence: 99%

Modifiable Risk Factors for Delayed Graft Function After Deceased Donor Kidney Transplantation

et al. 2019

View full text Add to dashboard Cite

show abstract

“…18 In a retrospective study of LDKT recipients (100 patients), the authors suggest that a CVP at reperfusion of 12 mm Hg was a factor associated with good early graft function, although the fall in creatinine trends was not significant. 19 Finally, 3 retrospective studies (77 deceased donor transplants recipients, 20 84 out of a cohort of 290 with a CVP measure LDKT, 21 149 patients mixed deceased and LDKT22) found no effect of specific CVP measures on graft outcome. In aggregate, there were no robust data indicating harm with CVP use as a guide if the mean CVP was maintained >5-8 mm Hg without overt fluid overload (CVP > 11 mm Hg), with higher temporary values at the time of reperfusion.…”

Section: Amount Of Fluid Administration and Cvpmentioning

confidence: 99%

Fluid Management During Kidney Transplantation: A Consensus Statement of the Committee on Transplant Anesthesia of the American Society of Anesthesiologists

et al. 2021

View full text Add to dashboard Cite

Background. Intraoperative fluid management may affect the outcome after kidney transplantation. However, the amount and type of fluid administered, and monitoring techniques vary greatly between institutions and there are limited prospective randomized trials and meta-analyses to guide fluid management in kidney transplant recipients. Methods. Members of the American Society of Anesthesiologists (ASA) committee on transplantation reviewed the current literature on the amount and type of fluids (albumin, starches, 0.9% saline, and balanced crystalloid solutions) administered and the different monitors used to assess fluid status, resulting in this consensus statement with recommendations based on the best available evidence. Results. Review of the current literature suggests that starch solutions are associated with increased risk of renal injury in randomized trials and should be avoided in kidney donors and recipients. There is no evidence supporting the routine use of albumin solutions in kidney transplants. Balanced crystalloid solutions such as Lactated Ringer are associated with less acidosis and may lead to less hyperkalemia than 0.9% saline solutions. Central venous pressure is only weakly supported as a tool to assess fluid status. Conclusions. These recommendations may be useful to anesthesiologists making fluid management decisions during kidney transplantation and facilitate future research on this topic.

show abstract

“…Pre-load dynamic measurements, such as Pulse-Pressure Variation (PPV) and Sroke-Volume Variation (SVV), can predict fluid responsiveness by analysis of heart-lung interaction triggered by positive pressure ventilation analogously to bedside Frank-Starling curve tests. 6 , 7 …”

mentioning

confidence: 99%

Volemia and kidney transplantation

Vieira

Carmona

2020

Brazilian Journal of Anesthesiology (English Edition)

View full text Add to dashboard Cite

Central venous pressure monitoring in living donor kidney recipients does not affect immediate graft function: A propensity score analysis

Abstract: In this single-center analysis, immediate post-transplant renal function was not associated with the use of intraoperative CVP monitoring.

Cited by 8 publications

References 19 publications

Modifiable Risk Factors for Delayed Graft Function After Deceased Donor Kidney Transplantation

Modifiable Risk Factors for Delayed Graft Function After Deceased Donor Kidney Transplantation

Fluid Management During Kidney Transplantation: A Consensus Statement of the Committee on Transplant Anesthesia of the American Society of Anesthesiologists

Volemia and kidney transplantation

Contact Info

Product

Resources

About