Robot Yardımlı Böbrek Naklinde Bifazlı Sıvı Tedavisi’nin Etkinliği

Abstract

Objective: Perioperative fluid treatment is among the factors affecting transplant kidney function. In this study, the efficacy of biphasic fluid treatment on per-operative patient stabilization and allograft kidney functions were evaluated. Material and Methods: Data of 65 robotic living releated donor kidney transplantation performed between 2015-2017 were retrospectively analyzed (16/04/2018, Protocol no 2018-07-13). The patients were divided as preemptive (Group Preemptif: GP, n=27) and non-preemptive group (Group Non-Preemptif: GNP, n=38). Biphasic fluid treatment was used in all cases (Phase 1 = before-vascular anastomosis 1-3 ml/kg/h and phase 2 = after-vascular anastomosis 10-12 ml/kg/h, respectively). Hemodynamic and biochemical status of the patients, early and late allograft kidney function were evaluated. Datas were statistically compared within and between the groups. Results: Hemodynamic/metabolic stability and diuresis were achieved after vascular anastomosis in all patients. There was no difference in the total amount of iv fluid given between the groups, except that the amount of fluid given in phase 1 was significantly less in GP (p<0.05). Pre-operative blood pH and HCO3 values were lower, Na+ and Cl- values were higher in GP(p<0.05). No difference was found in K+ and Ca+2 values at all times and pH values after extubation in both groups. Pre-operative blood urea and creatinine levels were significantly higher in GP (p<0.05) but all decreased to normal on postoperative 1 and 7 days. In long-term follow-up, both groups had similar mortality and rejection rates. Conclusion: Our results support that biphasic fluid treatment is effective to achieve hemodynamic/ metabolic stability and allograft kidney functions in robotic living releated kidney transplantation patients.