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Comparison between the effects of intraoperative human albumin and normal saline on early graft function in renal transplantation

  • Nephrology - Original Paper
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Abstract

Purpose

The aim of the current study was to compare the effects of intraoperative infusion of 20 % human albumin versus 0.9 % normal saline on early and late graft function in renal transplantation.

Methods

This prospective, randomized study was conducted on 44 patients with end-stage renal disease undergoing kidney transplantation. Patients were 32 males (72.7 %) and 12 females (27.3 %) with a mean age of 54.35 ± 11.15 years (range 20–58 years). Patients with cardiac disease and liver dysfunction were excluded from the study. Twenty-two of the 44 patients were given intraoperative intravenous infusion of 20 % human albumin with 0.9 % normal saline (albumin group), and the remaining 22 patients received intraoperative intravenous infusion of 0.9 % normal saline alone (saline group), as part of the intraoperative fluid hydration to keep central venous pressure between 10 and 15 mm of Hg.

Results

There was no statistically significant difference in mean intravenous fluid volume infused until the end of surgery between the saline group and the albumin group (P = 0.8326). Time of onset of diuresis and total intraoperative urine output were statistically insignificant between the two groups (P = 0.6255, P = 0.9231, respectively). Post-transplant serum creatinine on day 1, 3 and 5 between the albumin and saline groups were comparable (P = 0.8998, P = 0.7257, P = 0.8092, respectively). Post-transplant urine output on day 1, 3 and 5 between the albumin and saline groups were also comparable (P = 0.653, P = 0.9075, P = 0.946, respectively). Mean postoperative weight gain was higher in the saline group compared with the albumin group, but was not statistically significant (P = 0.6348).

Conclusions

This study revealed that the use of 20 % human albumin as an intraoperative volume expander provides no more benefit than the use of 0.9 % normal saline in terms of immediate graft function in living donor renal transplantation.

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References

  1. Oosterhof GO, Hoistma AJ, Witjes JA, Debruyne FM (1992) Diagnosis and treatment of urological complications in kidney transplantation. Urol Int 49(2):99–103

    Article  PubMed  CAS  Google Scholar 

  2. Ragaller MRJ, Theilen H, Koch T (2001) Volume replacement in critically ill patients with acute renal failure. J Am Soc Nephrol 12(17):S33–S99

    PubMed  Google Scholar 

  3. Kreimer U, Peter K (1998) Strategies of volume therapy in sepsis and systemic inflammatory response syndrome. Kidney Int 53(Suppl 64):75–79

    Google Scholar 

  4. Sharpe MD, Gelb AW (1999) Anesthesia and transplantation. Butterworth-Heinemann, USA, pp 241–267

    Google Scholar 

  5. Dawidson I, Berling E, Brynger H, Reisch J (1987) Intravascular volumes and colloid dynamics in relation to fluid management in living-related kidney donors and recipients. Crit Care Med 15:631–636

    Article  PubMed  CAS  Google Scholar 

  6. Najarian JS, Gulyassy PP, Stoney RJ, Duffy G, Braunstein P (1966) Protection of the donor kidney during homotransplantation. Ann Surg 164:398–417

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  7. Braun WE, Philips DF, Vidt DG, Novick AC, Nakamato S, Popowniak KL, Paganini E, Magnusson M, Pohl M, Steinmuller DR (1984) Coronary artery disease in 100 diabetics with end-stage renal failure. Transpl Proc 16:603–607

    CAS  Google Scholar 

  8. Starling EH (1896) On the absorption of fluids from connective tissue spaces. J Physiol (Lond) 19:312–326

    CAS  Google Scholar 

  9. Holbeck S, Grände PO (2000) Effects on capillary fluid permeability and fluid exchange of albumin, dextran, gelatin, and hydroxyethyl starch in cat skeletal muscle. Crit Care Med 28:1089–1095

    Article  PubMed  CAS  Google Scholar 

  10. Cochrane Injuries Group Albumin Reviewers (1998) Human albumin administration in critically ill patients: systematic review of randomised controlled trials. Br Med J 317:235–240

    Article  Google Scholar 

  11. Finfer S, Bellomo R, Boyce N, SAFE study investigators, (2004) A comparison of albumin and saline for fluid resuscitation in the intensive care unit. NEngl JMed 350:2247–2256

    Article  CAS  Google Scholar 

  12. Schnuelle P, Johannes van der Woude F (2006) Perioperative fluid management in renal transplantation: a narrative review of the literature. Transpl Int. 12:947–959

    Article  Google Scholar 

  13. Wang P, Ayala A, Dean RE, Hauptman JG, Ba ZF, Dejong GK, Chaudry IH (1991) Adequate crystalloid resuscitation restores but fails to maintain the active hepatocellular function following hemorrhagic shock. J Trauma 31:601–607

    Article  PubMed  CAS  Google Scholar 

  14. Baron JF (2000) Crystalloids versus colloids in the treatment of hypovolemic shock. In: Vincent J-L (ed) Yearbook of intensive care and emergency medicine. Springer, Berlin, pp 443–446

    Google Scholar 

  15. Yardimci A, Hadimioglu N (2005) An intraoperative fluid therapy fuzzy logic control system for renal transplantation. Eur J Control 11:572–585

    Article  Google Scholar 

  16. Othman MM, Ismael AZ, Hammouda GE (2010) The impact of timing of maximal crystalloid hydration on early graft function during kidney transplantation. Anesth Analg 110(5):1440–1446

    Article  PubMed  Google Scholar 

  17. Dawidson IJ, Sandor ZF, Coorpender L et al (1992) Intraoperative albumin administration affects the outcome of cadaver renal transplantation. Transpl 53:774–782

    Article  CAS  Google Scholar 

  18. Barron ME, Wilkes MM, Navickis RJ (2004) A systematic review of the comparative safety of colloids. Arch Surg 139:552–563

    Article  PubMed  CAS  Google Scholar 

  19. Laxenair MC, Charpentier C, Feldmon L (1994) Anaphylactoid reactions to colloid plasma substitute : incidence, risk factors, mechanism. A French multicenter study. Ann Fr Anesth Reanim 13:301

    Article  Google Scholar 

  20. Hadimioglu N, Saadawy I, Saglam T, Ertug Z, Dinckan A (2008) The effect of different crystalloid solutions on acid-base balance and early kidney function after kidney transplantation. Anesth Analg 107(1):264–269

    Article  PubMed  CAS  Google Scholar 

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The authors declare that they have no conflict of interest.

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Correspondence to Emad Abdallah.

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Abdallah, E., El-Shishtawy, S., Mosbah, O. et al. Comparison between the effects of intraoperative human albumin and normal saline on early graft function in renal transplantation. Int Urol Nephrol 46, 2221–2226 (2014). https://doi.org/10.1007/s11255-014-0785-z

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  • DOI: https://doi.org/10.1007/s11255-014-0785-z

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