It is generally believed that one of the most important factor determining immediate postoperative graft function is intraoperative management of the transplant recipient. Experimental and clinical studies have suggested measures to improve post-transplant kidney function, including intraoperative administration of fluides, mannitol, and calcium antagonist. Other pharmacological agents such as oxygen free radical scavengers, Prostaglandins, dopamine, and furosemide have also been suggested as beneficial to posttransplant function.
We studied 54 patients who underwent kidney transplant at our center between Jul. 1988 and Feb. 1992 to evaluate the effects of intraoperative fluid management on the outcome of renal transplantation in living donor, after restricted fluid infusion with only electrolyte solution (Group =l, n=27) and after maximal hydration accompanied by administration of albumin (Group=2, n=27). Donor and preoperative recipient parameters were comparable in the both group. Group 2 showed earlier urine onset than Group 1, (3422 min vs. 82=60 min. P<0.01) and larger urine volume(21 9 L vs. 11 5 L, P<0.01).
Serum creatinine level of the Group 2 on the first postoperative day was lower than that of Group 1(2.52 mg/dL vs. 3.52 mg/dL, P<0.05), but there was no difference after the third day. Fewer rejection episodes/patient occurred in group 2 during the follow-up period, but it was not a significant value(0.26f6 vs. 0.376).
The graft survival rate and the patient survival rate at 15 months were not different in the both groups. Our data indicates that the effect of intraoperative fluid management is also beneficial to the early postoperative period in living donor.
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