Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
Sci Rep. 2024 Oct 18;14(1):24505. doi: 10.1038/s41598-024-75474-2.
This study aims to analyze data from patients who received kidney transplantation from deceased donors to investigate the anesthetic factors influencing early and late graft outcomes, including the incidence of slow graft function (SGF), delayed graft function (DGF), and 3-year graft outcomes. We retrospectively analyzed 202 recipients who underwent deceased donor kidney transplantation from March 2010 to December 2020. Anesthetic monitoring data during the intraoperative period was analyzed at 5-minute intervals, and basic clinical parameters were evaluated. The mean recipient age was 46.6 ± 10.3 years, and the mean donor age was 41.7 ± 12.7 years. Anesthetic time averaged 285.8 ± 70.2 min, and operation time averaged 223.1 ± 44.0 min. The incidence of SGF was 11.8%, and the incidence of DGF was 3.9%. Mean central venous pressures (CVPs) were higher in recipients with SGF or DGF (11.7 mmHg) compared to those with immediate graft function (9.7 mmHg). Higher CVP was identified as an independent risk factor for SGF or DGF (odds ratio 1.219, p = 0.006). This study suggests that intraoperative monitoring of CVP is crucial for predicting short-term graft function in deceased donor kidney transplantation and should be managed to prevent excessive fluid intake.
本研究旨在分析接受已故供体肾移植患者的数据,以调查影响早期和晚期移植物结局的麻醉因素,包括慢移植肾功能(SGF)、迟发性移植肾功能(DGF)和 3 年移植物结局的发生率。我们回顾性分析了 202 例 2010 年 3 月至 2020 年 12 月期间接受已故供体肾移植的患者。分析术中期间每 5 分钟的麻醉监测数据,并评估基本临床参数。受者平均年龄为 46.6±10.3 岁,供者平均年龄为 41.7±12.7 岁。麻醉时间平均为 285.8±70.2 分钟,手术时间平均为 223.1±44.0 分钟。SGF 的发生率为 11.8%,DGF 的发生率为 3.9%。SGF 或 DGF 患者的平均中心静脉压(CVP)较高(11.7mmHg),而即刻移植物功能正常患者的 CVP 较低(9.7mmHg)。较高的 CVP 被确定为 SGF 或 DGF 的独立危险因素(优势比 1.219,p=0.006)。本研究表明,术中 CVP 监测对于预测已故供体肾移植的短期移植物功能至关重要,应加以管理以防止过度液体摄入。