• V Blasco, M Leone, F Antonini, A Geissler, J Albanèse, and C Martin.
• Département d'Anesthésie et de Réanimation, CHU Nord, Assistance Publique-Hôpitaux de Marseille, 13915 Marseille Cedex 20, France.
• Br J Anaesth. 2008 Apr 1;100(4):504-8.

BackgroundThe renal effect of hydroxyethylstarch (HES) solutions remains controversial. We hypothesized that the use of HES with a mean molecular weight of 130 kDa would reduce renal dysfunctions in the recipients. Our study was aimed at comparing the effects of two fluid regimens (HES 130/0.4 or HES 200/0.6) used for the resuscitation of brain-dead donors on the rate of delayed graft function (DGF) and the serum creatinine levels post-transplantation.MethodsThis retrospective matched-paired study was conducted in an intensive care unit of a university hospital. Case-controls were matched at the donor patient level as follows: gender, BMI, duration of ICU stay, serum creatinine levels, vasopressor, and volume of colloids. The organ donation from 64 brain-dead donors resulted in 115 transplants.ResultsThe renal function was similar among all donors. The characteristics of the recipients, including the cold ischaemia time, were similar. The rate of DGF was 22% in the donors treated with HES 130/0.4, compared with 33% in those treated with HES 200/0.6 (P=0.27). The serum creatinine levels at 1 month were 133 (38) micromol litre(-1) when the donors had been treated with HES 130/0.4 and 172 (83) micromol litre(-1) when they were treated with HES 200/0.6 (P=0.005). A difference was found 1 yr after transplantation [128 (36) vs147 (43) micromol litre(-1), P=0.05].ConclusionsUsing a modern, third-generation, rapidly degradable HES preparation with a low degree of substitution seems to be associated with a better effect on the renal function of recipients.

24 keywords...

hide…