O'Dair J, Evans L, Rigg K M, Shehata M
Nottingham Transplant Centre, Nottingham City Hospital NHS Trust, Nottingham, UK.
Transplant Proc. 2005 Mar;37(2):637-9. doi: 10.1016/j.transproceed.2004.12.211.
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.
We aimed to study the renoprotective effect on donor and recipient renal function of renal-dose dopamine during laparoscopic live-donor nephrectomy (LDN).
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.
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.
The intraoperative use of renal-dose dopamine during LDN seems to have no beneficial effect for either donor or recipient.
多巴胺作为肾移植中的肾脏保护剂，其作用尚不清楚。一些报告表明多巴胺可改善移植肾的初始功能和存活率，而其他报告则未能证实其有益效果。我们的活体供肾切除术项目由两名资深麻醉师负责，其中一位常规使用多巴胺，另一位则认为目前的证据不支持多巴胺在腹腔镜供肾切除术中具有肾脏保护作用。
我们旨在研究腹腔镜活体供肾切除术（LDN）期间肾剂量多巴胺对供体和受体肾功能的肾脏保护作用。
对1999年至2004年间的59对活体供体和受体进行回顾性分析。根据供体在LDN期间是否接受多巴胺输注进行分组。所有供体均接受哈特曼溶液以维持中心静脉压在12 mmHg。比较供体和受体在第1天、第7天和第6周时血清肌酐（SCr）的变化百分比。
在供体中，多巴胺输注对第1天SCr的平均升高百分比或第6周SCr的平均降低百分比没有影响。然而，在第7天，接受多巴胺的患者与未接受多巴胺的患者相比，SCr的降低幅度明显更大。在受体中，第1天、第7天或第6周时SCr的平均降低百分比没有显著差异。1年时的分析显示，供体和受体组之间的SCr没有显著差异。
LDN期间术中使用肾剂量多巴胺似乎对供体或受体均无有益作用。
