ORIGINAL ARTICLE
Year : 2019  |  Volume : 13  |  Issue : 2  |  Page : 23-29

Comparative effects of human albumin versus modern hydroxyethyl starch in living-donor renal transplant


Department of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo University, Giza, Egypt

Correspondence Address:
Ahmed K Mohammed
Department of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo University, Giza, 11562 Kasr Alaini
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejca.ejca_2_19

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Background Living-donor renal transplantation is considered the best therapy for renal failure patients. The outcome and graft function are affected by various perioperative variables. Fluid management remains a controversy whether to use crystalloids or colloids with the effect of either type of solution on graft function and overall morbidity. Patients and methods We studied 120 patients with end-stage renal disease, who were on regular hemodialysis scheduled for living-related kidney transplantation. The patients were assigned to receive either 6% hydroxylethyl starch (HES) 130/0.4 (Voluven) (HES group: n=60) or albumin 5% (ALB group: n=60) for intraoperative use. In both groups, normal saline was administered at 10 ml/kg/h. In addition, patients received 250 ml boluses of either Voluven (HES group) with a maximum of 50 ml/kg/day or ALB 5% (ALB group) to maintain their central venous pressure between 12 and 15 mmHg. Blood transfusion was given based on the hemoglobin level (<7 g/dl). Hemodynamic variables (mean arterial pressure and central venous pressure) were recorded. We recorded the cold and warm ischemia times, the operative time and the time of start of graft diuresis. Urine output, serum creatinine, blood urea nitrogen (BUN), and International Normalized Ratio (INR) were recorded by the end of surgery, then every 24 h during the first 3 postoperative days and once again on day 7. Creatinine clearance was calculated on post-transplant days 1, 2, 3, and 7. The need for postoperative dialysis within the first week and the incidence of early graft rejection were noted. Results There were no statistically significant differences between the two groups regarding hemodynamic variables, onset of diuresis, or need for postoperative dialysis. Perioperative laboratory workup (BUN, creatinine, creatinine clearance, and INR) were similar in both study groups. Conclusion There are no statistically significant differences between the use of HES solutions and ALB 5% on the outcome of living-donor renal transplant recipients. Using either solutions is comparable to the other with no special side effects.


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