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Effects of the Type of Intraoperative Fluid in Living Donor Kidney Transplantation: A Single-Center Retrospective Cohort Study

 Seungho Jung  ;  Jeongmin Kim  ;  Juhan Lee  ;  Su Youn Choi  ;  Hye Ji Joo  ;  Bon-Nyeo Koo 
 YONSEI MEDICAL JOURNAL, Vol.63(4) : 380-388, 2022-03 
Journal Title
Issue Date
Humans ; Kidney ; Kidney Transplantation* / adverse effects ; Living Donors ; Retrospective Studies ; Transplant Recipients
Kidney transplantation ; Plasma-lyte ; acid-base balance ; fluid therapy ; glomerular filtration rate
Purpose: Perioperative fluid management in kidney transplant recipients is crucial to supporting the fluid, acid-base, and electrolyte balance required for graft perfusion. However, the choice of intraoperative crystalloids in kidney transplantation remains controversial. We conducted a single-center retrospective cohort study to evaluate the impact of intraoperative fluids on acid-base and electrolyte balance and graft outcomes.

Materials and methods: We included 282 living donor kidney transplant recipients from January 2010 to December 2017. Patients were classified into two groups based on the type of intraoperative crystalloids used (157 patients in the half saline group and 125 patients in the balanced crystalloid solutions group, Plasma-lyte).

Results: Compared with the half saline group, the Plasma-lyte group showed less metabolic acidosis and hyponatremia during surgery. Hyperkalemia incidence was not significantly different between the two groups. Changes in postoperative graft function assessed by blood urea nitrogen and creatinine were significantly different between the two groups. Patients in the Plasma-lyte group exhibited consistently higher glomerular filtration rates than those in the half saline group at 1 month and 1 year after transplantation after adjusting for demographic differences.

Conclusion: Intraoperative Plasma-lyte can lead to more favorable results in terms of acid-base balance during kidney transplantation. Patients who received Plasma-lyte showed superior postoperative graft function at 1 month and 1 year after transplantation. Further studies are needed to evaluate the superiority of intraoperative Plasma-lyte over other types of crystalloids in relation to graft outcomes.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Koo, Bon-Nyeo(구본녀) ORCID logo https://orcid.org/0000-0002-3189-1673
Kim, Jeongmin(김정민) ORCID logo https://orcid.org/0000-0002-0468-8012
Lee, Ju Han(이주한)
Jung, Seungho(정승호) ORCID logo https://orcid.org/0000-0001-6220-6766
Choi, Su Youn(최수연)
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