Post-reperfusion Syndrome during Renal Transplantation: A Retrospective Study

Abstract

Post-reperfusion syndrome (PRS) is a serious, widely reported complication following the reperfusion of an ischemic tissue or organ. We sought to determine the prevalence, risk factors and short-term outcomes of PRS related renal transplantation. We conducted a retrospective, case-control study of patients undergoing renal transplantation between July 2006 and March 2008. Identification of PRS was based on a drop in mean arterial pressure by at least 15% within 5 minutes of donor kidney reperfusion. Of the 150 consecutive renal transplantations reviewed, 6 patients (4%) met criteria for post-reperfusion syndrome. Univariate analysis showed that an age over 60, diabetes mellitus, Asian race, and extended criteria donors increased the odds of developing PRS by 4.8 times (95% CI [1.2, 20]; P=.0338), 4.5 times (95% CI [1.11, 18.8]; P=.0378), 35.5 times (95% CI [3.94, 319.8]; P=0.0078) and 9.6 times (95% CI [1.19, 76.28] P=0.0115) respectively. Short term follow-up revealed increased graft failure rate within 6 months (6% vs. 16% P=0.0125) and almost twice the number of hospital days post-transplant in PRS cohorts (5.43 ± 2.29 vs. 10.8 ± 7.29 P=<0.0001). Despite limited reporting, PRS appears to be a relatively common complication of renal transplantation and is associated with increase morbidity.

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“…They found 6 patients out of 150 patients fulfilled this postperfusion syndrome criteria, and 1 of these patients had graft loss. 8 Our case had hypotension just after reperfusion that lasted more than 1 minute (10 h), but she did not have persistent bradycardia, so she was incompatible with the postperfusion syndrome. Vasoplegic syndrome is usually seen after cardiac surgeries and is characterized by low invasive arterial blood pressure, high cardiac index (> 2.5 L/min/m 2 ) and low systemic vascular resistance (< 800 dyn.s.cm-5).…”

Efficacy of clonidine as an adjuvant to ropivacaine in transversus abdominis plane block in adult renal transplant recipients: A double-blinded randomized controlled trial

“…There might be multiple causes of postoperative hypotension after renal transplantation such as intraoperative fluid shifts, intraoperative excessive diuretic use, blood loss during surgery, and postreperfusion syndrome. [ 30 31 ]…”

Latex anaphylaxis in a recipient child during kidney transplant performed in a latex-free environment: case report

“…Criteria for its diagnosis include reduction in blood pressure to values ​​less than 30% from baseline, with a minimum duration of one minute, occurring within the first five minutes after reperfusion. 5 Although such hemodynamic instability was observed, other cardiovascular changes were also observed, such as tachycardia and bronchospasm, which favor the diagnosis of latex allergy more. Moreover, post-reperfusion syndrome during kidney transplant is rare, estimated at 4%.…”