Comparison between the effects of intraoperative human albumin and normal saline on early graft function in renal transplantation

Abdallah, Emad; El-Shishtawy, Samya; Mosbah, Osama; Zeidan, Mohamed A.

doi:10.1007/s11255-014-0785-z

Cited by 12 publications

(7 citation statements)

References 16 publications

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“…11,12 Colloids too have been studied, but with inconclusive results. [13][14][15] Irrespective of fluid type, adequate perfusion of the renal allograft is important to reduce DGF risk; hence, many anesthesiologists favor liberal administration of fluids during kidney transplantation, 16 despite inconclusive evidence to support this practice. 5,6,10,17 The RELIEF trial examined a restrictive versus liberal fluid strategy in 3000 patients undergoing major abdominal surgery.…”

Section: Introductionmentioning

confidence: 99%

Intravenous Fluid Management Practices in Kidney Transplant Patients: A Multicenter Observational Cohort Pilot Study

Efune

Zerillo

Zhou

et al. 2020

Semin Cardiothorac Vasc Anesth

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Background Limited evidence exists with regard to best practices in fluid management during kidney transplantation, which may directly affect the incidence of DGF. The authors of this study embarked on a collaborative observational multicenter pilot study to evaluate fluid administration practices in different transplant centers, with a focus on the relationship between total administered crystalloid volume and its association with DGF. Methods Twenty consecutive kidney transplant patients were included from 9 academic medical centers in the United States. One hundred eighty patients were included in the final cohort and variables were compared between patients with and without DGF. Administered crystalloid volume was the primary variable of interest; however, additional patient and surgical variables were compared between patients with and without DGF. Variation in crystalloid administration was explored between centers by comparing median administered crystalloid volumes per kilogram of body weight. Also, unadjusted and adjusted logistic regression analyses were performed to determine which variables were independently associated with DGF. Results Multivariable regression modeling demonstrated that cold ischemic time and ephedrine use during surgery were independently associated with DGF. There was no independent association between administered crystalloid volume and DGF. Conclusion In this study of patients having kidney transplantation, we did not find an independent association between administered crystalloid volume and DGF, although there was significant variability in crystalloid administration between centers. Our data suggest that DGF was driven mainly by surgical factors such as cold ischemic time. Ephedrine was also independently associated with DGF, which should be explored in future studies.

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Section: Introductionmentioning

confidence: 99%

Intravenous Fluid Management Practices in Kidney Transplant Patients: A Multicenter Observational Cohort Pilot Study

Efune

Zerillo

Zhou

et al. 2020

Semin Cardiothorac Vasc Anesth

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“…The geriatric nutritional risk index (GNRI) was developed as a simple and objective nutritional assessment tool for hospitalized elderly patients (aged ≥ 65 years, according to World Health Organization definition of elderly; https://www.who.int/) based on their body weight and serum albumin level [5]. Albumin is affected by agerelated changes such as hydration and hepatic and renal dysfunction [6][7][8]. In addition, body weight appears to be a good indicator of both the severity of systemic illness and the amount of protein-calorie stores [9,10].…”

Section: Introductionmentioning

confidence: 99%

Preoperative geriatric nutritional risk index is a useful prognostic indicator in elderly patients with gastric cancer

et al. 2020

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Background: The geriatric nutritional risk index (GNRI) was developed to evaluate the prognosis in elderly hospitalized patients at risk of malnutrition and related morbidity and mortality. This study aimed to evaluate the relationship between preoperative GNRI and long-term outcomes in elderly gastric cancer patients. Materials and Methods: We retrospectively reviewed 297 consecutive patients aged ≥ 65 years who underwent laparoscopic gastrectomy with R0 resection and evaluated their overall survival (OS) and cancer-specific survival (CSS). Results: In the univariate analyses, OS was significantly associated with the American Society of Anesthesiologists Physical Status (ASA-PS), tumor size, tumor differentiation, pathological stage, carcinoembryonic antigen (CEA), C-reactive protein, postoperative complications, and GNRI, whereas in the univariate analyses of CSS, ASA-PS, tumor size, tumor differentiation, pathological stage, CEA, postoperative adjuvant chemotherapy, and GNRI were significantly associated with poor prognosis. In the multivariate analysis, ASA-PS, tumor differentiation, pathological stage, and GNRI were significant independent prognostic factors of OS, whereas ASA-PS, pathological stage, and CEA were significant independent prognostic factors of CSS.Conclusions: GNRI is significantly associated with OS and CSS in elderly gastric cancer patients and is an independent predictor of OS. It is a simple, cost-effective, and promising nutritional index for predicting OS in elderly patients.

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“…In a prospective randomized trial of 20% human albumin + 0.9% saline versus 0.9 % saline alone in LDKT recipients, there were no differences in the graft outcome. 35 A similar study (80 LDKT recipients), also using 20% albumin, also found no differences in graft function, although no patient had delayed graft function requiring dialysis. 36 A recent study evaluated kidneys from deceased donors (after neurological death) who received colloid (primarily gelatin [68%], less frequently albumin [17%], and starch [17%]) with crystalloid compared to crystalloid alone (data for 143/181 transplanted kidneys from 100 donors).…”

Section: Albuminmentioning

confidence: 78%

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

et al. 2021

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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.

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Comparison between the effects of intraoperative human albumin and normal saline on early graft function in renal transplantation

Abstract: This study revealed that the use of 20 % human albumin as an intraoperative volume expander provides no more benefit than the use of 0.9 % normal saline in terms of immediate graft function in living donor renal transplantation.

Cited by 12 publications

References 16 publications

Intravenous Fluid Management Practices in Kidney Transplant Patients: A Multicenter Observational Cohort Pilot Study

Intravenous Fluid Management Practices in Kidney Transplant Patients: A Multicenter Observational Cohort Pilot Study

Preoperative geriatric nutritional risk index is a useful prognostic indicator in elderly patients with gastric cancer

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

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