Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
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Saudi J Kidney Dis Transpl · Nov 2014
Randomized Controlled TrialEffect of intraoperative human albumin on early graft function in renal transplantation.
Adequate intravascular volume maintenance is essential to ensure early graft function during renal transplantation. Various recommendations on optimum fluid therapy are based, at best, on sparse evidence, and that too only from observational studies. This prospective randomized controlled study was done to evaluate the effect of 20% human albumin on the early graft function in living donor renal transplantation. ⋯ Postoperative change in body weight [1.89±3.82 vs. 2.48±3.89 (kg)], tissue edema (10% vs. 7.5%), and pulmonary edema (2.5% vs. 5%) did not differ significantly (P>0.05). Twenty percent human albumin given intraoperatively, as a volume expander, does not improve early graft function in living donor renal transplantation. It should be used selectively rather than as a routine protocol.
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Saudi J Kidney Dis Transpl · Nov 2014
Randomized Controlled Trial Comparative StudyPreinduction hemodynamic fluctuations in renal transplant recipients--comparison of two combined anesthesia regimens.
An ideal anesthetic technique for a renal allograft recipient must ensure hemodynamic stability, enhance graft reperfusion, and provide good postoperative pain relief. Hence, a combined general and epidural anesthesia is preferred. In our clinical practice, it has been observed that in chronically ill end-stage renal disease (ESRD) patients, a bolus injection of epidural local anesthetics invariably necessitated the use of vasopressor agents. ⋯ These hypotensive episodes required a therapeutic intervention prior to general anesthesia, that is, intravenous mephenteramine (3-6 mg; 9.60±2.32 mg) and crystalloid infusion (189.28±21.29 mL). Intraoperative hemodynamic parameters, surgical blood loss, and transplanted kidney function were comparable between the groups. We concluded that the use of regional anesthetics needed to administered cautiously in renal transplant recipients to maintain hemodynamic parameters.