TY - JOUR
T1 - Intraoperative fluid management and kidney transplantation outcomes
T2 - A retrospective cohort study
AU - Harbell, Monica W.
AU - Kraus, Molly B.
AU - Bucker-Petty, Skye A.
AU - Harbell, Jack W.
N1 - Funding Information:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Publisher Copyright:
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2021/12
Y1 - 2021/12
N2 - Background: Patients undergoing kidney transplantation traditionally receive liberal amounts of fluid during surgery. However, excessive fluids can lead to fluid overload and ileus. In this retrospective cohort study, we compared the effect of restrictive versus liberal fluid therapy on kidney transplantation outcomes. Methods: Patients who underwent deceased-donor kidney transplantation at Mayo Clinic from January 2014 to March 2019 were included. Those who received <3 L of intravenous fluids intraoperatively were categorized as “restrictive;” those who received ≥3 L were categorized as “liberal.” The primary outcome was incidence of delayed graft function (DGF). Secondary outcomes included length of stay, readmission within 30 days, time to return of bowel function, and incidence of postoperative complications. Results: Of the 1171 patients included, 557 were in the restrictive group and 614 in the liberal group. The mean (SD) fluid intake was 2.17 (.54) L in the restrictive group and 3.67 (.68) L in the liberal group (P<.001). There was no difference in DGF (relative risk, 1.03; P =.56), length of stay (P =.34), readmission (P =.80), return of bowel function (P =.71), or other postoperative complications. Conclusions: Intraoperative restrictive fluid therapy during kidney transplantation was not associated with DGF or worse outcomes when compared with liberal fluid therapy.
AB - Background: Patients undergoing kidney transplantation traditionally receive liberal amounts of fluid during surgery. However, excessive fluids can lead to fluid overload and ileus. In this retrospective cohort study, we compared the effect of restrictive versus liberal fluid therapy on kidney transplantation outcomes. Methods: Patients who underwent deceased-donor kidney transplantation at Mayo Clinic from January 2014 to March 2019 were included. Those who received <3 L of intravenous fluids intraoperatively were categorized as “restrictive;” those who received ≥3 L were categorized as “liberal.” The primary outcome was incidence of delayed graft function (DGF). Secondary outcomes included length of stay, readmission within 30 days, time to return of bowel function, and incidence of postoperative complications. Results: Of the 1171 patients included, 557 were in the restrictive group and 614 in the liberal group. The mean (SD) fluid intake was 2.17 (.54) L in the restrictive group and 3.67 (.68) L in the liberal group (P<.001). There was no difference in DGF (relative risk, 1.03; P =.56), length of stay (P =.34), readmission (P =.80), return of bowel function (P =.71), or other postoperative complications. Conclusions: Intraoperative restrictive fluid therapy during kidney transplantation was not associated with DGF or worse outcomes when compared with liberal fluid therapy.
KW - clinical decision-making
KW - delayed graft dysfunction
KW - fluid therapy
KW - hospital discharge
KW - hospital readmission
KW - kidney (allograft) function/dysfunction
KW - postoperative complications
KW - quality of care/care delivery
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U2 - 10.1111/ctr.14489
DO - 10.1111/ctr.14489
M3 - Article
C2 - 34546602
AN - SCOPUS:85116801325
SN - 0902-0063
VL - 35
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 12
M1 - e14489
ER -