The Use of High Volume Perioperative Normal Saline Increases the Risk of Delayed Graft Function after Kidney Transplantation
1Anesthesia & Perioperative Care, University of California San Francisco, San Francisco, CA, 2Dept. of Medical Education, University Istanbul – Cerrahpasa, Istanbul, Turkey, 3School of Medicine, George Washington University, Washington, DC, 4Dept. of Surgery, Division of Transplantation, University of California San Francisco, San Francisco, CA, 5Anesthesia & Perioperative Care, and Dept. of Surgery, Division of Transplantation, University of California San Francisco, San Francisco, CA
Meeting: 2019 American Transplant Congress
Abstract number: D394
Keywords: Graft function, Kidney, Metabolic complications, Multivariate analysis
Session Information
Session Name: Poster Session D: Late Breaking
Session Type: Poster Session
Date: Tuesday, June 4, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Metabolic and physiologic effects of high volume perioperative Normal Saline (NS) resuscitation are well described, but the impact on delayed graft function (DGF) remains unclear. We investigated whether high volume perioperative administration of NS affects the incidence of DGF in patients undergoing kidney transplant (KT).
*Methods: After IRB approval, we utilized a cohort of patients undergoing deceased and living donor KT from 2005 to 2015 at a single academic center. This study used data from the Scientific Registry of Transplant Recipients (SRTR). The SRTR data system includes data on all donor, wait-list candidates, and transplant recipients in the US, submitted by the members of the Organ Procurement and Transplantation Network (OPTN). The Health Resources and Services Administration, U.S. Dept. of Health and Human Services provides oversight to the activities of the OPTN and SRTR contractors.* We linked SRTR outcome data with two institutional electronic anesthesia record databases. Of 2904 matched records, 1997 had complete records and were included in the final analysis. We fit a logistic regression model with DGF as primary outcome, NS group (high, intermediate, low) as primary predictor and adjusted for potential confounders.
*Results: Overall, 2.96 ± 1.32 L (mean ± SD) crystalloids were administered. Sixty percent of patients received more than 80% of total crystalloids in form of NS (high), 25% received 30 to 80% (intermediate) NS, and 15% received less than 30% (low) NS. In the adjusted model, the odds ratio of DGF was 1.50 (95% CI: 1.03 – 2.20, p=0.036) for the high NS group, and 1.38 (95% CI 0.92 -2.07, p=0.123) for the intermediate NS group, as compared to the low NS group.
*Conclusions: Our preliminary data analysis indicates that the perioperative administration of predominantly NS does significantly and independently contribute to DGF in patients undergoing kidney transplantation. Avoidance of NS should be considered for routine implementation. *The data reported have been supplied by the Minneapolis Medical Research Foundation as the contractor for SRTR. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy of or interpretation by the SRTR or the U.S. Government.
To cite this abstract in AMA style:
Kolodzie K, Cakmakkaya OS, Boparai ES, Tavakol M, Feiner J, Niemann CU. The Use of High Volume Perioperative Normal Saline Increases the Risk of Delayed Graft Function after Kidney Transplantation [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/the-use-of-high-volume-perioperative-normal-saline-increases-the-risk-of-delayed-graft-function-after-kidney-transplantation/. Accessed May 18, 2025.« Back to 2019 American Transplant Congress