Routine use of renal-dose dopamine during living donor nephrectomy has no beneficial effect to either donor or recipient.

BACKGROUND

The use of dopamine as a renoprotective agent in kidney transplantation remains unclear. Some reports suggest that dopamine improves initial graft function and survival, while others have failed to demonstrate a beneficial effect. Our live-donor nephrectomy program is serviced by 2 senior anesthetists, one who routinely uses dopamine and the other who considers that current evidence does not support a renoprotective effect of dopamine in laparoscopic donor nephrectomy.

PURPOSE

We aimed to study the renoprotective effect on donor and recipient renal function of renal-dose dopamine during laparoscopic live-donor nephrectomy (LDN).

METHODS

A retrospective analysis was performed of 59 live donor and recipient pairs between 1999 and 2004. Donors were grouped according to whether they received dopamine infusion during LDN. All donors received Hartmann solution to maintain the central venous pressure at 12 mm Hg. The percentage change in serum creatinine (SCr) in both donors and recipients was compared at day 1, day 7, and week 6.

RESULTS

In the donors, dopamine infusion had no effect on the mean percentage rise in SCr at day 1 or the mean percentage decrease in SCr at week 6. At day 7, however, patients who received dopamine had a significantly greater decrease in SCr compared with those who did not. In the recipients, there was no significant difference in the mean percentage decrease in SCr at days 1 or 7 or at week 6. Analysis at 1 year revealed no significant difference in sCr among the groups of donors and recipients.

CONCLUSIONS

The intraoperative use of renal-dose dopamine during LDN seems to have no beneficial effect for either donor or recipient.