Haemodynamics, fluids & transfusion
Goal-Directed Hemodynamic Therapy in Deceased-Donor Kidney Transplantation: A Prospective Paired-Kidney Study
Authors' conclusion
FloTrac-guided GDHT safely restricts intraoperative fluid administration and optimizes early systemic flow. Avoiding unnecessary volume expansion mitigates iatrogenic vasoplegia and reduces rescue vasopressor requirements, while facilitating excellent early allograft recovery.
Study context
- Population
- Patients with end-stage renal disease receiving kidney transplants from 20 brain-dead donors (20 matched pairs)
- Participants
- 40 patients · 20 matched pairs
- Comparison
- FloTrac-guided goal-directed hemodynamic therapy (GDHT) vs central venous pressure (CVP)-guided therapy
Methodological detailsprospective, paired-kidney design, single-centre
- Prospective
- Paired-kidney design
- Single-centre
Further findings
Total intravenous fluid · Intraoperative
P = 0.011
Rescue vasopressors
P = 0.001
Postoperative serum creatinine trajectories and delayed graft function · delayed graft function rates
| Outcome | P value |
|---|---|
| MAP · Intraoperative | P = 0.914 |
| Stroke volume index · 15 minutes postinduction | P = 0.033 |
| CVP · Throughout surgery | P = 0.002 |
MAP · Intraoperative
- MAP remained equivalent
Stroke volume index · 15 minutes postinduction
- Higher early stroke volume index with GDHT
CVP · Throughout surgery
- Lower CVP with GDHT
Postoperative serum creatinine trajectories and delayed graft function
- Identical between cohorts
Original publication
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