The effects of diltiazem and dopamine on early graft function in renal transplant recipients

Dönmez, Aslı; Karaaslan, Dilek; Şekerci, Sumru; Akpek, Elif; Karakayalı, H.; Arslan, G.

doi:10.1016/s0041-1345(99)00736-8

Cited by 13 publications

(7 citation statements)

References 6 publications

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“…Despite occasional reports that the perioperative administration of dopamine to the transplant recipient enhanced the graft’s effective plasma flow, urine production, or tubular sodium excretion, kidney function remained largely unaffected . Hence, the available evidence from clinical studies does not support the routine use of renal dose dopamine to the recipient after transplantation (Table ).…”

Section: Dopamine Administered To the Transplant Recipientmentioning

confidence: 99%

“…Despite occasional reports that the perioperative administration of dopamine to the transplant recipient enhanced the graft's effective plasma flow, urine production, or tubular sodium excretion, [7][8][9] kidney function remained largely unaffected. 8,[10][11][12][13] Hence, the available evidence from clinical studies does not support the routine use of renal dose dopamine to the recipient after transplantation ( Table 2). These findings are in accordance with broad clinical evidence that the use of low-dose dopamine in the critically ill with impending or overt renal failure does not protect kidney function, despite transient improvements in renal medullary perfusion.…”

Section: Dopamine Adminis Tered To the Tr An S Pl Ant Recipientmentioning

confidence: 99%

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Dopamine in transplantation: Written off or comeback with novel indication?

Schnuelle¹,

Benck

Yard

2018

Clinical Transplantation

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Renal-dose dopamine has fallen out of favor in the intensive care unit (ICU) during past years due to its ineffectiveness to prevent impending or to ameliorate overt renal failure in the critically ill. By contrast, growing evidence indicates that low-dose dopamine administered to the stable organ donor after brain death confirmation improves the clinical course of transplanted organs after kidney and heart transplantation. Ensuring a thorough monitoring for potential circulatory side effects, employment of dopamine at a dose of 4 μg/kg/min is safe in the deceased donor. Among recipients, the advantageous effect is easy to achieve, inexpensive, and devoid of adverse side effects. The mode of action relies on dopamine's propensity to mitigate injury in various cell systems from isolated transplantable organs under cold storage conditions. The present review article summarizes the clinical evidence of dopamine donor pretreatment in solid organ transplantation and focuses on the underlying molecular mechanisms of cellular protection. Introducing the routine use of low-dose dopamine for the management of the brain-dead donor in the ICU before procurement provides an evidence-based strategy to improve graft outcome after kidney transplantation without conferring harm to non-renal grafts, namely to livers and hearts, in cases of multi-organ donation.

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Section: Dopamine Administered To the Transplant Recipientmentioning

confidence: 99%

Section: Dopamine Adminis Tered To the Tr An S Pl Ant Recipientmentioning

confidence: 99%

Dopamine in transplantation: Written off or comeback with novel indication?

Schnuelle¹,

Benck

Yard

2018

Clinical Transplantation

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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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“…8,9 Pathways including oxidative stress, lipid peroxidation, cold injury, and calcium influx have been shown to trigger inflammation and apoptosis in IRI. 18 In prior studies, CCBs have been found beneficial in prevention of acute tubular necrosis immediately post-renal transplant and in prevention of calcineurin inhibitor induced nephrotoxicity. 1,2,8,[10][11][12][13][14][15] Maneuvers directed at modifying calcium-dependent pathways could theoretically prevent or limit IRI and cell death.…”

Section: Introductionmentioning

confidence: 99%

“…16,17 Calcium channel blockers (CCBs) have been shown to have a potential role in prevention and management of ischemic renal insufficiency. 18 In prior studies, CCBs have been found beneficial in prevention of acute tubular necrosis immediately post-renal transplant and in prevention of calcineurin inhibitor induced nephrotoxicity. [19][20][21][22] It has been shown that CCBs administration immediately before ischemic injury was more beneficial than giving it after ischemic injury.…”

Section: Introductionmentioning

confidence: 99%

Does intra‐operative verapamil administration in kidney transplantation improve graft function

Gupta

Caldas

Sharma

et al. 2019

Clinical Transplantation

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The role of the calcium channel blocker (verapamil) in kidney transplant is controversial. Verapamil has been hypothesized to mitigate ischemia reperfusion injury (IRI) to the allograft. Herein, we evaluated the effect of intra-operative verapamil administration in a large cohort of kidney transplants. Total 684 transplants were performed during 2007-2017. Of these, 348 (50.9%) transplants received verapamil (2.5 mg) Ver (+), and 336 (49.1%) did not, Ver (−). Based on the donor type, the study was divided into three groups; living donor (LD) (N = 270), neurological determination of death (NDD) (N = 394), and donation after cardiac death (DCD) (N = 20). Ver (−) subgrouphad more diabetic recipients as compared to Ver (+) subgroup in LD and NDD groups (P < 0.05). No significant difference was found for delayed graft function in any of the group (P > 0.05). Cold ischemia time and dialysis requirement were significantly higher in Ver (+) LD and NDD groups, respectively. Except for DCD group, there was no significant difference in eGFR (mL/min) immediately and 6 months after kidney transplant in any of the groups. Furthermore, univariate and multivariate logistic regression analysis was performed to account for potential confounders, but verapamil administration did not improve graft function in any of the groups (P > 0.05) after transplant. K E Y W O R D Scalcium channel blocker, ischemia reperfusion injury, kidney transplantation

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The effects of diltiazem and dopamine on early graft function in renal transplant recipients

Cited by 13 publications

References 6 publications

Dopamine in transplantation: Written off or comeback with novel indication?

Dopamine in transplantation: Written off or comeback with novel indication?

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

Does intra‐operative verapamil administration in kidney transplantation improve graft function

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