Skip to main content

Table 1 Monitoring and targeting of fluid therapy in kidney transplantation and the main outcomes

From: Perioperative fluid management in kidney transplantation: a black box

Reference

Year

Type of donor

Study design

Number of patients

Study group and aim

Main outcomes

Srivastava et al. [66]

2015

Living

Prospective nonrandomized control

110 Study, 104 control

Intraoperative fluid management TED-guided vs CVP-guided (historical controls)

Same rate of immediate graft functions in both groups. Less amount of fluid and less postoperative complications in TED-guided group

Aulakh et al. [27]

2015

Living

Retrospective

100

CVP > 12 mmHg vs CVP < 12 mmHg

Good early graft function if CVP = 12 mmHg

Aulakh et al. [27]

2015

Living

Retrospective

100

MAP > 100 mmHg vs MAP < 100 mmHg

Good early graft function if MAP > 95 mmHg

Toyoda et al. [60]

2015

Living

Prospective observational

31

SVV vs CVP vs DPAP as an estimate of RVEDVI in the same study group

SVV is a better indicator of preload

Chin et al. [73]

2014

No data

Retrospective

635

Ability of SVV to predict CVP in the same study group

SVV of 6% as an alternative to CVP of 8 mmHg

Gingell-Littlejohn et al. [28]

2013

No data

Observational

149

Effect of MAP on DGF

MAP < 70 mmHg associated with DGF

Campos et al. [4]

2012

No data

Retrospective

1966

Effect of MAP and CVP on graft function

Greater graft survival associated with MAP ≥ 93 mmHg. Perioperative fluid administration < 2500 ml associated with greater graft survival, whereas CVP ≥ 11 mmHg associated with high rates of ARE and chronic graft dysfunction

Bacchi et al. [37]

2010

Deceased

Observational

155

Correlation of CVP with DGF

CVP ≤ 8 mmHg correlates with DGF. Fluid input ≤ 2.25 L correlates with DGF

Othman et al. [7]

2010

Living

Randomized

40

Constant infusion rate of NaCl 0.9% at 10–12 ml/kg/h vs CVP at 5 mmHg during preischemia time. Post ischemia, the aim was CVP 8–10 mmHg in both groups

CVP target group had better graft function. Both groups received approximately 3 L of crystalloids. The CVP target group required fewer vasopressors and diuretics and had less postoperative tissue edema

Snoeijs et al. [5]

2007

Deceased (nonheart-beating)

Retrospective observational

177

Correlation of hemodynamic data with PNF of the graft

Average CVP < 6 mmHg and MAP < 110 mmHg were significant predictors of PNF. Preoperative diastolic BP < 80 mmHg was associated with PNF

Ferris et al. [30]

2003

Deceased and living

Retrospective

77

< 25% decline in CVP vs 25–50% decline in CVP vs > 50% decline in CVP in the immediate post-transplantation period

Neither absolute CVP nor % drop in CVP appeared to influence the rate on ATN. Reperfusion injury or related effects may be responsible for the CVP drop. No influence of volume of fluids infused on occurrence of ATN

Tóth et al. [11]

1998

Deceased

Prospective

121

Correlation of hemodynamic data with nonfunctioning grafts vs delayed graft function vs good graft function

Good graft function group had higher MAP (108 ± 26 mmHg)

Thomsen et al. [8]

1987

Deceased and living (51 vs 10)

Prospective nonrandomized control

61 (30 in group I, 31 in group II)

CVP not measured vs CVP kept > 5 cmH2O

Onset of graft function: Group I, 30%; Group II, 62%

Carlier et al. [10]

1982

Deceased

Prospective observational

120

Mean PAP ≤ 20 mmHg and diastolic PAP ≤ 15 mmHg vs mean PAP > 20 mmHg and DPAP > 15 mmHg

36% of ATN in Group I vs only 6% in Group II

  1. ARE acute renal failure, ATN acute tubular necrosis, BP blood pressure, CVP central venous pressure, DGF delayed graft function, DPAP diastolic pulmonary artery pressure, MAP mean arterial pressure, PNF primary nonfunction, PAP pulmonary artery pressure, RVEDVI right ventricular end-diastolic pressure, SVV stroke volume variation, TED transesophageal Doppler