Low-Dose Dopamine in Kidney Transplantation

Ciapetti, Marco; Valvasone, S Di; Filippo, Alessandro Di; Cecchi, A; Bonizzoli, Manuela; Peris, Adriano

doi:10.1016/j.transproceed.2009.08.058

Cited by 41 publications

(34 citation statements)

References 12 publications

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“…There is no evidence to indicate that dopamine improves renal perfusion or diminishes the risk of delayed graft function after transplantation when administered to the recipient, 214 although data indicate some benefit for kidney function if given to the deceased donor. 215 In some recipients, dopamine may increase heart rate, blood pressure, and myocardial workload, effects that may increase the risk for an ischemic event.…”

Section: Perioperative Medical Management Of Cardiovascular Risk Befomentioning

confidence: 99%

Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates

Lentine¹,

Costa²,

Weir³

et al. 2012

Circulation

278

159

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Section: Perioperative Medical Management Of Cardiovascular Risk Befomentioning

confidence: 99%

Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates

Lentine¹,

Costa²,

Weir³

et al. 2012

Circulation

278

159

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“…[16] In addition, the use of dopamine during kidney transplantation had no beneficial effect on early graft function. [17] Ciapetti et al [18] also reported a higher mortality and prolonged intensive care unit stays in patients receiving dopamine after renal transplantation. Cardiovascular morbidity was increased through alterations of arterial function characterized by diminished distensibility of large arteries.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and outcomes associated with a higher use of inotropes in kidney transplant recipients

Choi

Baik

et al. 2017

Medicine

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Preservation of adequate perfusion pressures to the graft is a main focus of intraoperative management during kidney transplantation. We undertook this study to investigate the incidence of the higher use of inotropes in kidney transplant recipients and identify the patient outcomes and preoperative and intraoperative variables related to this.We retrospectively analyzed 1053 patients who underwent kidney transplantation at Asan Medical Center between January 2006 and February 2012, stratified by their inotropic score ([dopamine] + [dobutamine] + [epinephrine × 100] + [norepinephrine × 100]) <7 versus ≥7, wherein all doses are expressed as μg/kg/min. We evaluated preoperative characteristics, hemodynamic parameters, and intraoperative variables as well as postoperative outcomes, such as length of hospital stay and 1-year rejection and mortality rate.Receiver-operating characteristic analysis was performed to determine inotropic score to predict 1-year mortality. An inotropic score of 7 had the best combined sensitivity and specificity. An inotropic score ≥7 (137 patients, 13.0%) was significantly more prevalent in older patients, those with polycystic kidney disease, and at a 2nd transplant. Anesthesia time, the amounts of crystalloid and 5% albumin infused, and the need for red blood cell transfusion were significantly higher in the inotropic score ≥7 group. The patients with a higher use of inotropes required longer postoperative hospital stay and experienced a >2-fold higher rejection within the 1st year and a 4-fold higher 1-year mortality rate.A higher use of inotropes in kidney transplant recipients is more prevalent in older patients, those with a 2nd transplant and in patients with polycystic kidney disease as their primary renal disease. The postoperative hospital stay, rejection within the 1st year, and 1-year mortality rate are increased in patients with an inotropic score ≥7.

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“…Dopamine administration is not recommended in the early posttransplant period. [15][16][17][18] Whether delayed administration monitored by the graft vascular tone could benefit graft function is beyond the reach of our study. The dopaminergic pathway may have been transiently disrupted by the release of reactive oxygen species or by calcium homeostasis changes after ischemia followed by reperfusion injury.…”

Section: Discussionmentioning

confidence: 99%

“…14 Although infusion of a "renal dopamine dose" has been suggested to provide better renal tissue perfusion and better preservation of transplant function, so far, there is no clinical evidence either for or against this strategy. [15][16][17][18] A study looking specifically at renal perfusion by noninvasive transparietal Doppler supports an absence of effect of dopamine on transplanted kidneys in the early phase of reperfusion, which could explain the lack of clinical benefits. 19 In this study, we hypothesized that the effect of dopamine on renal transplant blood flow and function may differ according to time after transplant and the resolution of the effects of ischemiareperfusion injury.…”

Section: Introductionmentioning

confidence: 99%

Untitled

Bataille

Payen²,

Villiers³

et al. 2016

Exp Clin Transplant

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Objectives: The relation between dopamine infusion and renal hemodynamics and function has not been studied in renal allografts during early recovery. We analyzed the dose response of dopamine infusion on renal blood flow and function in human kidney transplant recipients at reperfusion and during early graft recovery. Conclusions: Immediately after transplant, kidney grafts with ischemic-reperfusion injury are fully dilated and do not respond to dopamine. The specific renal effects observed are due to systemic hemodynamic status. Vascular responsiveness to a "renal dopamine dose" returns on graft recovery.

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Low-Dose Dopamine in Kidney Transplantation

Cited by 41 publications

References 12 publications

Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates

Cardiac Disease Evaluation and Management Among Kidney and Liver Transplantation Candidates

Risk factors and outcomes associated with a higher use of inotropes in kidney transplant recipients

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