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Preconditioning effects of the anesthetic administered to the donor on grafted kidney function in living donor kidney transplantation recipients

 Lee JH  ;  Joo DJ  ;  Kim JM  ;  Park JH  ;  Kim YS  ;  Koo BN 
 MINERVA ANESTESIOLOGICA, Vol.79(5) : 504-514, 2013 
Journal Title
Issue Date
Adult ; Anesthetics/therapeutic use* ; Creatinine/blood ; Electrocardiography ; Female ; Glomerular Filtration Rate/drug effects ; Glomerular Filtration Rate/physiology ; Humans ; Kidney/physiology* ; Kidney Transplantation/methods* ; Lipocalins/blood ; Lipocalins/urine ; Living Donors* ; Male ; Prospective Studies ; Reperfusion Injury/prevention & control* ; Retrospective Studies ; Treatment Outcome
Anesthetics ; general - Kidney transplantation- Living donors - Ischemic preconditioning
BACKGROUND: In living donor kidney transplantation (LDKT), we evaluated if there was any difference in grafted kidney function according to the type of anesthetic used in the donor because some laboratory studies have demonstrated that volatile anesthetics at clinically relevant concentrations protect the kidneys against renal ischemia-reperfusion injury.

METHODS: In part I of the study, we retrospectively compared grafted kidney function [serum creatinine levels (Cr) and estimated glomerular filtration rates (eGFR) in recipients of LDKT] according to the type of donors' volatile anesthetic (sevoflurane [group Sevo, 166 patients], isoflurane [group Iso, 55] or desflurane [group Des, 61]). In part II, we prospectively compared grafted kidney function and neutrophil gelatinase-associated lipocalin (NGAL) levels in the serum and urine of recipients according to the anesthetic used in the donor (desflurane [group Des, N.=50] vs. propofol [group Pro, N.=50]).

RESULTS: In part I, the eGFR of the Des group was greater than that of the Sevo or Iso groups (P=0.017) until POD 7. However, in part II, there were no significant changes in Cr and eGFR by POD 7, no differences in the levels of NGAL in the serum and urine on POD 1 and 2, or in Cr and eGFR on the day of discharge between the Des and Pro groups.

CONCLUSIONS: The inhalational anesthetic administered to donors does not improve grafted kidney function in recipients undergoing LDKT to a greater extent than propofol.
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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, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Kim, Jeongmin(김정민) ORCID logo https://orcid.org/0000-0002-0468-8012
Park, Jin Ha(박진하) ORCID logo https://orcid.org/0000-0002-1398-3304
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0001-6679-2782
Joo, Dong Jin(주동진) ORCID logo https://orcid.org/0000-0001-8405-1531
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