Comparison of the novel hydroxyethylstarch 130/0.4 and hydroxyethylstarch 200/0.6 in brain-dead donor resuscitation on renal function after transplantation.

Abstract

BACKGROUND:

The renal effect of hydroxyethylstarch (HES) solutions remains controversial. We hypothesized that the use of HES with a mean molecular weight of 130 kDa would reduce renal dysfunctions in the recipients. Our study was aimed at comparing the effects of two fluid regimens (HES 130/0.4 or HES 200/0.6) used for the resuscitation of brain-dead donors on the rate of delayed graft function (DGF) and the serum creatinine levels post-transplantation.

METHODS:

This retrospective matched-paired study was conducted in an intensive care unit of a university hospital. Case-controls were matched at the donor patient level as follows: gender, BMI, duration of ICU stay, serum creatinine levels, vasopressor, and volume of colloids. The organ donation from 64 brain-dead donors resulted in 115 transplants.

RESULTS:

The renal function was similar among all donors. The characteristics of the recipients, including the cold ischaemia time, were similar. The rate of DGF was 22% in the donors treated with HES 130/0.4, compared with 33% in those treated with HES 200/0.6 (P=0.27). The serum creatinine levels at 1 month were 133 (38) micromol litre(-1) when the donors had been treated with HES 130/0.4 and 172 (83) micromol litre(-1) when they were treated with HES 200/0.6 (P=0.005). A difference was found 1 yr after transplantation [128 (36) vs147 (43) micromol litre(-1), P=0.05].

CONCLUSIONS:

Using a modern, third-generation, rapidly degradable HES preparation with a low degree of substitution seems to be associated with a better effect on the renal function of recipients.

• Authors: V Blasco, M Leone, F Antonini, A Geissler, J Albanèse, C Martin
• Journal: British journal of anaesthesia (Br J Anaesth) Vol. 100 Issue 4 Pg. 504-8 (Apr 2008) ISSN: 1471-6771 [Electronic] England
• PMID: 18256055 (Publication Type: Comparative Study, Journal Article)

Chemical References

• HES 130-0.4
• Hydroxyethyl Starch Derivatives
• Plasma Substitutes
• hydroxyethylstarch 200
• Creatinine

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Brain Death
• Case-Control Studies
• Creatinine (blood)
• Delayed Graft Function
• Female
• Humans
• Hydroxyethyl Starch Derivatives (analogs & derivatives, therapeutic use)
• Kidney (physiology)
• Kidney Transplantation (physiology)
• Male
• Middle Aged
• Plasma Substitutes (therapeutic use)
• Resuscitation (methods)
• Tissue Donors