Effect of recipients' peri-operative parameters on the outcome of kidney transplantation

In this prospectively collected data base multifactorial study, the influen ce of the peri-operative recipients' parameters on the transplanted kidney function were examined. One hundred and twenty-one patients who underwent f irst cadaver kidney transplantation in our unit were involved and were foll owed up for another 2 yr. The recipients were divided into three groups. Gr oup I, patients with non-functioning grafts, group II, with delayed graft f unction, and group III, with good graft function. All routinely measured pa rameters were involved in the examination. The pre-operative haematocrit le vel differed significantly among the three groups. Significant intra-operat ive differences were found among the three groups in mean arterial pressure , (group I: 81 +/- 31 mmHg, group II: 90 +/- 24 mmHg, vs. group III: 108 +/ - 26 mmHg, p < 0.01) at 5 min before revascularisation. The patients who ha d better post-operative kidney function, had lower pre-operative haematocri t level, and higher blood pressure in the different phase of operation, tha n those who had post-operative kidney function problems. The second warm is chaemic time in Group III was significantly shorter than in group I. (Group I: 51.5 min vs. group II: 47 min, vs. group III: 46.3 min, p < 0.001.) Rej ection rate was higher during the first 5 post-operative days in patients w ith non-functioning grafts. (Group I: 53% and group II: 24% vs, group III: 12% p < 0.001.) The other examined parameters had not differed significantl y among the three groups. The kidney function differences observed in the e arly (first 5 d) post-operative period, remained similar at the end of the next 2 yr. According to our results the peri-operative fluid-balance is one of the most important factors which may influence the success of the kidne y transplantation.