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Is brain-dead donor fluid therapy with colloids associated with better kidney grafts?

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Title: Is brain-dead donor fluid therapy with colloids associated with better kidney grafts?
Author(s): Limnell, Niko
Contributor: University of Helsinki, Faculty of Medicine
Discipline: Anaesthesiology and Intensive Care Medicine
Language: English
Acceptance year: 2015
Background: Fluid therapy is required to maintain the perfusion to donor organs. Recent reviews on the choices of fluids have emphasized the safety of using crystalloids, as opposed to fluid therapy with colloids, which has been reported either unequivocal or potentially harmful in a number of studies on various patient populations. We aimed to analyze if the type of fluids given to donors is connected with the outcome of kidney transplantation. Methods: A total of 100 consecutive brain-dead multi-organ donors and the respective 181 kidney recipients were studied retrospectively. Data concerning donor fluid therapy, the characteristics of the donors and the recipients, and the outcome after kidney transplantation were extracted from organ retrieval and patient records. Cases with early graft function (EGF) were compared to cases with delayed graft function (DGF). Results: The donor had received both crystalloids and colloids in most cases (84 %). Fluid therapy with crystalloids alone was more common among the 40 recipients with delayed graft function (30 %) than the 103 recipients with early graft function (11 %) (P=0.005). Donor age, time on dialysis before transplantation and donor fluid therapy with crystalloids alone were independent risk factors for delayed graft function in multivariate analysis. Conclusion: Our results suggest that donor fluid therapy including colloids could be beneficial instead of harmful when compared to treatment with crystalloids alone. This finding needs to be evaluated in prospective studies.
Keyword(s): Colloid Delayed graft function Fluid therapy Gelatine Kidney transplantation

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