Emerging trends in transplantationKidney transplantationComparison of the Effects of Normal Saline Versus Plasmalyte on Acid-Base Balance During Living Donor Kidney Transplantation Using the Stewart and Base Excess Methods
Section snippets
Methods
After obtaining approval from our Institutional Review Board, 60 patients scheduled for elective living donor kidney transplantation between August 2011 and April 2012 were enrolled in this study. Ages of the enrolled patients ranged from 21 to 67 years. All patients were American Society of Anesthesiologist physical status III to IV. Exclusion criteria included severe cardiovascular or respiratory disease.
One day before transplant surgery, patients were assigned to either the NS group (n = 30)
Results
All 60 enrolled patients successfully completed the study. There were no significant differences in patient characteristics between the 2 groups, including duration of kidney ischemia and intraoperative input and output (Table 1). The time from the skin incision to iliac vein clamping was 124 ± 29 minutes in the NS and 127 ± 23 minutes in the Plasmalyte group. The time from iliac vein clamping to reperfusion was 36 ± 6 minutes in the NS vs 35 ± 6 minutes in the Plasmalyte group.
Changes in serum
Discussion
This randomized, double-blinded study showed that compared with Plasmalyte, NS administration worsened metabolic acidosis by significantly reducing pH, BE, and SIDe throughout the postreperfusion period during living donor kidney transplantation. Patients given NS showed hyperchloremic rather than dilutional metabolic acidosis. The beneficial effect of Plasmalyte on acid-base balance during the postreperfusion period, however, was not associated with improved postoperative graft function.
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