Comparison of hydroxyethyl starch and succinylated gelatin in cadaver renal graft function in kidney-transplant recipients

摘要

Hydroxyethyl starch solution (HES) is increasingly used during kidney transplantation for compensation of hypovolemia. However, the advantages of HES remain unclear. This clinical trial compared the effect of administering 6% HES 130/0.4 and 4% succinylated gelatin (SG) for volume replacement on the rate of delayed graft function (DGF), the occurrence of sensitive markers of renal impairment, and peritransplantation indexes of hemodynamic stability. After exclusion, 71 patients aged 23 to 64 years who underwent cadaver kidney transplantation were enrolled. Of these, 36 received 6% HES 130/0.4 and 35 were given 4% SG for volume replacement. The rate of DGF; the levels of beta 2-microglobulin (β2-MG), alpha 1-microglobulin (α1-MG), blood urea nitrogen (BUN), and serum creatinine (sCr); and the peritransplantation urine volume were determined and used as primary investigative parameters. The HES group showed a significant postoperative decrease in serum β2-MG, BUN, and sCr. Postoperative urine levels of β2-MG and α1-MG also decreased significantly in patients who received HES (p?< 0.001) and postoperative urine volume was significantly higher in the HES group as compared to the SG group (p?= 0.0012). No significant hemodynamic stability differences were seen between patients who received HES or SG colloids; however, 6% hydroxyethyl starch 130/0.4 led to better recovery outcomes in patients who underwent cadaver kidney transplantation.