Perioperative Dexmedetomidine Improves Outcomes of Kidney Transplant

Perez, Richard V; Mattos, Angelo M. de; Wang, Cecilia; Li, Zhongmin; Liu, Hong

doi:10.1111/cts.12826

Cited by 16 publications

(37 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The long-term outcomes of the surgery patients were also evaluated on postoperative day 30, 60, and 90. There were no differences identified between two groups in urea, Cr, β2-MG, CysC, and eGFR at the first 3 months, which is similar to other retrospective studies [42].…”

Section: Discussionsupporting

confidence: 90%

“…In addition, Dex can attenuate inflammatory cytokines, such as TNF and IL-6, by inhibiting the activation of ERK1/2 and NF-κB and modulating inflammatory mediators, therefore, reducing the systemic inflammatory response and improving outcomes in kidney transplantation [12,25,36,[39][40][41]. A retrospective study revealed that Dex could reduce the incidence of DGF, posttransplantation risk of infection, acute rejection, and length of hospital stay in kidney transplantation [42]. We also compared the incidence of DGF and length of hospital stay in this study and detected less hospital stay in Dex group.…”

Section: Discussionmentioning

confidence: 99%

“…Computational and Mathematical Methods in Medicine KIM-1 is recognized as a transmembrane glycoprotein with immunoglobulin and mucin-like domains; its expression is at low levels in normal kidney tissue or urine but significantly increasing in damaged proximal tubules after IRI or other types of kidney diseases, and its expression was related to the degree of kidney damage [42][43][44][45][46][47][48][49]. KIM-1 has been proven to be an independent predictor of long-term graft loss and also valuable for the prediction of adverse outcome of inflammatory kidney injury [50,51].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Renoprotective Effect of Intraoperative Dexmedetomidine in Renal Transplantation

Liu

Jin

Feng

et al. 2022

Computational and Mathematical Methods in Medicine

View full text Add to dashboard Cite

Background. Renal dysfunction after kidney transplantation may be influenced by many reasons. This study was designed to evaluate whether the administration of dexmedetomidine (Dex) could ameliorate renal function and prognosis after kidney transplantation. Methods. A total of 65 patients were divided into Dex group ( n = 33 ) and Con group (Con, n = 32 ). Dex group intravenously received an initial loading dose of 0.6 μg/kg Dex for 15 min before anaesthesia induction, followed by a rate of 0.4 μg/kg/h until 30 min after kidney reperfusion. By contrast, Con group received saline. The concentration of urinary kidney injury molecule-1 (KIM-1), serum creatinine (Cr), blood urea, urine output, β2 microglobulin (β2-MG), Cystatin C (CysC), and estimated glomerular filtration rate (eGFR) was recorded and compared between two groups during the course of the hospitalization or follow-up. Mean arterial pressure (MAP) and heart rate (HR), vasoactive drugs, and anaesthetics were recorded during the operation. Pain degree was evaluated using a visual analogue scale (VAS) after operation. Delayed graft function (DGF), graft loss, length of hospital stay, and mortality were compared between groups. Results. The concentration of KIM-1 in Dex group was lower than Con group at 2 h ( P = 0.018 ), 24 h ( P = 0.013 ), 48 h ( P < 0.01 ), and 72 h ( P < 0.01 ) after reperfusion. MAP of Dex group after tracheal intubation ( P = 0.012 ) and incision ( P = 0.018 ) and HR after intubation ( P = 0.021 ) were lower than that of Con group. The dosage of sufentanil during operation in Dex group was less than Con group ( P = 0.039 ). Patients that used atropine in Dex group were more than Con group ( P = 0.027 ). Patients who received Dex presented with lower VAS scores at 6 h ( P = 0.01 ) and 12 h ( P = 0.002 ) after operation. Concentration of serum Cr and blood urea had no significant differences between groups before operation and on postoperative day 1 to 6. Urine output was recorded for 6 days after operation and had no differences between groups. Also, no differences were identified between two groups in urea, Cr, β2-MG, CysC, and eGFR in the first 3 months after operation. Incidence of DGF after operation was detected no difference between groups, while length of hospital stay in Dex group was less than Con group ( P = 0.012 ). Conclusion. Dex can decrease kidney injury marker level, attenuate perioperative stress, relieve the dosage of sufentanil and postoperative pain, and reduce length of hospital stay. However, Dex is not associated with changes in prognosis in the first 3 months after transplantation.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Renoprotective Effect of Intraoperative Dexmedetomidine in Renal Transplantation

Liu

Jin

Feng

et al. 2022

Computational and Mathematical Methods in Medicine

View full text Add to dashboard Cite

show abstract

“…Because this study did not aim to investigate differences in daily urine output, our non-significantly higher daily urine output at POD1 and POD2 after dexmedetomidine treatment may suggest that further studies are warranted to investigate dexmedetomidine’s effect on urine output after kidney transplantation. In addition, a retrospective cohort study reported that perioperative dexmedetomidine uses the reduced incidence of delayed graft function, risk of infection, risk of acute rejection, overall complication, and length of hospital stay [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of perioperative dexmedetomidine infusion on renal function and microcirculation in kidney transplant recipients: a randomised controlled trial

Wang

Lee

et al. 2022

Annals of Medicine

View full text Add to dashboard Cite

Objective Ischemia-reperfusion injury affects postoperative transplanted kidney function in kidney transplant recipients. Dexmedetomidine was reported to attenuate ischemia-reperfusion injury and improve microcirculation, but its propensity to cause bradycardia and hypotension may adversely affect microcirculation. This study investigated the effect of dexmedetomidine on postoperative renal function and sublingual microcirculation in kidney recipients. Methods The enrolled kidney transplant recipients were randomly allocated to the control group or dexmedetomidine group. After anaesthesia induction, patients in the dexmedetomidine group received dexmedetomidine infusion until 2 h after surgery. Sublingual microcirculation was recorded using an incident dark-field video microscope and analysed. The primary outcomes were the creatinine level on a postoperative day 2 and total vessel density at 2 h after surgery. Results A total of 60 kidney recipients were analysed, and the creatinine levels on postoperative day 2 were significantly lower in the dexmedetomidine group than in the control group (1.5 (1.1–2.4) vs. 2.2 (1.7–3.0) mg/dL, median difference −0.6 (95% CI, −0.7 to −0.5) mg/dL, p = .018). On a postoperative day 7, the creatinine levels did not differ significantly between the two groups. Total vessel density at 2 h after surgery did not differ significantly between the two groups. Conclusion We found that early postoperative renal function was better in kidney transplant recipients receiving dexmedetomidine infusion, but total vessel density was not significantly different between the intervention and control groups. Key messages Ischemia-reperfusion injury affects postoperative transplanted kidney function, and dexmedetomidine was reported to attenuate ischemia-reperfusion injury and improve microcirculation in other clinical conditions. This study showed that early postoperative renal function was better in kidney transplant recipients receiving dexmedetomidine. Dexmedetomidine’s side effect of bradycardia and hypotension may affect microcirculation, our results revealed that the perioperative sublingual microcirculation did not differ significantly in kidney transplant recipients receiving dexmedetomidine.

show abstract

“… 12 A retrospective cohort study suggested that dexmedetomidine use was associated with decreased incidence of DGF after isolated kidney transplant or multiorgan transplant. 13 However, to date, no randomized clinical trial has investigated the effect of dexmedetomidine on kidney allograft function.…”

Section: Introductionmentioning

confidence: 99%

Effect of Perioperative Dexmedetomidine on Delayed Graft Function Following a Donation-After-Cardiac-Death Kidney Transplant

Shan

Wang

et al. 2022

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

show abstract

Perioperative Dexmedetomidine Improves Outcomes of Kidney Transplant

Abstract: Dexmedetomidine in Kidney Transplant Chen et al. 47. Calvani, J. et al. In situ multiplex immunofluorescence analysis of the inflammatory burden in kidney allograft rejection: a new tool to characterize the alloimmune response.

Cited by 16 publications

References 44 publications

Renoprotective Effect of Intraoperative Dexmedetomidine in Renal Transplantation

Renoprotective Effect of Intraoperative Dexmedetomidine in Renal Transplantation

Effects of perioperative dexmedetomidine infusion on renal function and microcirculation in kidney transplant recipients: a randomised controlled trial

Effect of Perioperative Dexmedetomidine on Delayed Graft Function Following a Donation-After-Cardiac-Death Kidney Transplant

Contact Info

Product

Resources

About