The impact of intraoperative fluid management during laparoscopic donor nephrectomy on donor and recipient outcomes.

Abstract:

BACKGROUND:Intraoperative fluid management during laparoscopic donor nephrectomy (LDN) may have a significant effect on donor and recipient outcomes. We sought to quantify variability in fluid management and investigate its impact on donor and recipient outcomes. METHODS:A retrospective review of patients who underwent LDN from July 2011 to January 2016 with paired kidney recipients at a single center was performed. Patients were divided into tertiles of intraoperative fluid management (standard, high, and aggressive). Donor and recipient demographics, intraoperative data, and postoperative outcomes were analyzed. RESULTS:Overall, 413 paired kidney donors and recipients were identified. Intraoperative fluid management (mL/h) was highly variable with no correlation to donor weight (kg) (R = 0.017). The aggressive fluid management group had significantly lower recipient creatinine levels on postoperative day 1. However, no significant differences were noted in creatinine levels out to 6 months between groups. No significant differences were noted in recipient postoperative complications, graft loss, and death. There was a significant increase (P < 0.01) in the number of total donor complications in the aggressive fluid management group. CONCLUSIONS:Aggressive fluid management during LDN does not improve recipient outcomes and may worsen donor outcomes compared to standard fluid management.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Williams AM,Kumar SS,Bhatti UF,Biesterveld BE,Kathawate RG,Sung RS,Woodside KJ,Englesbe MJ,Alameddine MB,Waits SA

doi

10.1111/ctr.13542

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

e13542

issue

6

eissn

0902-0063

issn

1399-0012

journal_volume

33

pub_type

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