Aulakh Navpreet Kaur, Garg Kamakshi, Bose Abhishek, Aulakh Baldev Singh, Chahal Harmandeep Singh, Aulakh Gurmehar Singh
Department of Biochemistry, Dayanand Medical College and Hospital, Ludhiana, India.
Department of Anaesthesia, Dayanand Medical College and Hospital, Ludhiana, India.
J Anaesthesiol Clin Pharmacol. 2015 Apr-Jun;31(2):174-9. doi: 10.4103/0970-9185.155144.
Early graft function is crucial for successful kidney transplantation. The aim of our study was to evaluate the effect of intra-operative central venous pressure (CVP) and mean arterial pressure (MAP) on early graft function and biochemical outcome.
This was a retrospective study carried out on patients undergoing renal transplant only from live-related donors between March 2011 and May 2013. We mainly divided the patients into two groups based on CVP and mean MAP. One group had CVP more than 12 and other with CVP <12 mmHg at the time of declamping. Further one group was with mean MAP >100 mmHg and other with mean MAP of <100 mmHg. The graft outcome of genetically related and genetically unrelated donors was also evaluated in early postoperative period. The trend in fall of serum creatinine was studied during the first five post-operative days. The effect of age, dry weight, sex, relation with donor and intraoperative factors like MAP and CVP on early graft function were analysed. Correlation analysis, analysis of variance test (ANOVA) and multivariate analysis technique were used in this study for statistical computation.
The mean CVP at the time of declamping was 13.91 mmHg. The minimum CVP was 6 mmHg in one patient who had ischemic heart disease with low ejection fraction. All 5 days mean serum creatinine values were comparable in two groups on 1(st), 2(nd), 3(rd) and 4(th) postoperative days. The mean MAP at the time of declamping was 111.22 mmHg. Mean MAP varied from a minimum of 95 mmHg to maximum of 131 mmHg. There was no significant difference in two groups on 1(st), 2(nd), 3(rd), 4(th) and 5(th) postoperative days.
A CVP around 12 mmHg and mean MAP >95 mmHg with good perioperative fluid hydration is associated with good early graft function.
早期移植肾功能对于肾移植成功至关重要。本研究旨在评估术中中心静脉压（CVP）和平均动脉压（MAP）对早期移植肾功能及生化指标结果的影响。
这是一项回顾性研究，研究对象为2011年3月至2013年5月间仅接受活体亲属供肾肾移植的患者。我们主要根据CVP和平均MAP将患者分为两组。一组在松开血管夹时CVP高于12，另一组CVP<12 mmHg。进一步将一组平均MAP>100 mmHg，另一组平均MAP<100 mmHg。还评估了术后早期基因相关和基因不相关供体的移植结果。研究了术后头五天血清肌酐下降的趋势。分析了年龄、干体重、性别、与供体的关系以及术中因素如MAP和CVP对早期移植肾功能的影响。本研究采用相关分析、方差分析（ANOVA）和多变量分析技术进行统计计算。
松开血管夹时的平均CVP为13.91 mmHg。一名射血分数低的缺血性心脏病患者的最低CVP为6 mmHg。术后第1、2、3和4天，两组的所有5天平均血清肌酐值具有可比性。松开血管夹时的平均MAP为111.22 mmHg。平均MAP最低为95 mmHg，最高为131 mmHg。术后第1、2、3、4和5天两组之间无显著差异。
CVP约为12 mmHg且平均MAP>95 mmHg并伴有良好的围手术期液体水化与良好的早期移植肾功能相关。
