Perioperative Dexmedetomidine Improves Outcomes of Kidney Transplant.

Abstract

Graft function is crucial for successful kidney transplantation. Many factors may affect graft function or cause delayed graft function (DGF), which decreases the prognosis for graft survival. This study was designed to evaluate whether the perioperative use of dexmedetomidine (Dex) could improve the incidence of function of graft kidney and complications after kidney transplantation. A total of 780 patients underwent kidney transplantations, 315 received intravenous Dex infusion during surgery, and 465 did not. Data were adjusted with propensity scores and multivariate logistic regression was used. The primary outcomes are major adverse complications, including DGF and acute rejection in the early post-transplantation phase. The secondary outcomes included length of hospital stay (LOS), infection, overall complication, graft functional status, post-transplantation serum creatinine values, and estimated glomerular filtration rate (eGFR). Dex use significantly decreased DGF (19.37% vs. 23.66%; adjusted odds ratio, 0.744; 95% confidence interval, 0.564-0.981; P = 0.036), risk of infection, risk of acute rejection in the early post-transplantation phase, the risk of overall complications, and LOS. However, there were no statistical differences in 90-day graft functional status or 7-day, 30-day, and 90-day eGFR. Perioperative Dex use reduced incidence of DGF, risk of infection, risk of acute rejection, overall complications, and LOS in patients who underwent kidney transplantation.

• Authors: Jun Chen, Richard Perez, Angelo Mario de Mattos, Cecilia Wang, Zhongmin Li, Richard L Applegate 2nd, Hong Liu
• Journal: Clinical and translational science (Clin Transl Sci) Vol. 13 Issue 6 Pg. 1279-1287 (11 2020) ISSN: 1752-8062 [Electronic] United States
• PMID: 32506659 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of the American Society for Clinical Pharmacology and Therapeutics.

Chemical References

• Adrenergic alpha-2 Receptor Agonists
• Dexmedetomidine
• Creatinine

Topics

• Adrenergic alpha-2 Receptor Agonists (administration & dosage)
• Adult
• Aged
• Allografts (drug effects)
• Creatinine (blood)
• Dexmedetomidine (administration & dosage)
• Female
• Glomerular Filtration Rate (drug effects)
• Graft Rejection (diagnosis, epidemiology, etiology, prevention & control)
• Graft Survival (drug effects)
• Humans
• Incidence
• Kidney (drug effects)
• Kidney Transplantation (adverse effects)
• Length of Stay (statistics & numerical data)
• Male
• Middle Aged
• Perioperative Care (methods)
• Retrospective Studies
• Risk Factors
• Treatment Outcome
• Young Adult