THE EFFECT OF DOPAMINE ON GRAFT FUNCTION IN PATIENTS UNDERGOING RENAL-TRANSPLANTATION

We studied the effect of a low-dose dopamine infusion on graft functio n in 60 patients undergoing transplantation with cadaveric kidneys in a prospective controlled trial. Recipients were allocated to either a control or a do amine group, the latter receiving a 3 mug.kg-1.min-1 i nfusion of dopamine starting intraoperatively. Evaluation of dopamine' s effect was undertaken in two stages, namely, (i) initial graft funct ion 1 wk after transplantation and (ii) graft survival at 3 mo. Initia l graft function was determined by the ability of the transplanted kid ney to reduce serum creatinine, and the development of acute tubular n ecrosis as confirmed by renal biopsy. Of the dopamine group 33.3% deve loped acute tubular necrosis compared to 23.3% of the control group. T he second-stage evaluation was based on plasma creatinine levels and t he requirement for dialysis within 3 mo of transplantation. 92.8% of t he dopamine group and 76.9% of the control group had good graft functi on. No statistically significant difference between the two groups was found. The perioperative infusion of dopamine at 3 mug.kg-1.min-1 was not shown to have any beneficial effect on the transplanted kidney in patients who do not have serious vascular disease, or who do not rece ive kidneys subjected to prolonged hypotension or prolonged preservati on or anastamotic times.