Table 1.
Monitoring and targeting of fluid therapy in kidney transplantation and the main outcomes
| Reference | Year | Type of donor | Study design | Number of patients | Study group and aim | Main outcomes |
|---|---|---|---|---|---|---|
| Srivastava et al. [66] | 2015 | Living | Prospective nonrandomized control | 110 Study, 104 control | Intraoperative fluid management TED-guided vs CVP-guided (historical controls) | Same rate of immediate graft functions in both groups. Less amount of fluid and less postoperative complications in TED-guided group |
| Aulakh et al. [27] | 2015 | Living | Retrospective | 100 | CVP > 12 mmHg vs CVP < 12 mmHg | Good early graft function if CVP = 12 mmHg |
| Aulakh et al. [27] | 2015 | Living | Retrospective | 100 | MAP > 100 mmHg vs MAP < 100 mmHg | Good early graft function if MAP > 95 mmHg |
| Toyoda et al. [60] | 2015 | Living | Prospective observational | 31 | SVV vs CVP vs DPAP as an estimate of RVEDVI in the same study group | SVV is a better indicator of preload |
| Chin et al. [73] | 2014 | No data | Retrospective | 635 | Ability of SVV to predict CVP in the same study group | SVV of 6% as an alternative to CVP of 8 mmHg |
| Gingell-Littlejohn et al. [28] | 2013 | No data | Observational | 149 | Effect of MAP on DGF | MAP < 70 mmHg associated with DGF |
| Campos et al. [4] | 2012 | No data | Retrospective | 1966 | Effect of MAP and CVP on graft function | Greater graft survival associated with MAP ≥ 93 mmHg. Perioperative fluid administration < 2500 ml associated with greater graft survival, whereas CVP ≥ 11 mmHg associated with high rates of ARE and chronic graft dysfunction |
| Bacchi et al. [37] | 2010 | Deceased | Observational | 155 | Correlation of CVP with DGF | CVP ≤ 8 mmHg correlates with DGF. Fluid input ≤ 2.25 L correlates with DGF |
| Othman et al. [7] | 2010 | Living | Randomized | 40 | Constant infusion rate of NaCl 0.9% at 10–12 ml/kg/h vs CVP at 5 mmHg during preischemia time. Post ischemia, the aim was CVP 8–10 mmHg in both groups | CVP target group had better graft function. Both groups received approximately 3 L of crystalloids. The CVP target group required fewer vasopressors and diuretics and had less postoperative tissue edema |
| Snoeijs et al. [5] | 2007 | Deceased (nonheart-beating) | Retrospective observational | 177 | Correlation of hemodynamic data with PNF of the graft | Average CVP < 6 mmHg and MAP < 110 mmHg were significant predictors of PNF. Preoperative diastolic BP < 80 mmHg was associated with PNF |
| Ferris et al. [30] | 2003 | Deceased and living | Retrospective | 77 | < 25% decline in CVP vs 25–50% decline in CVP vs > 50% decline in CVP in the immediate post-transplantation period | Neither absolute CVP nor % drop in CVP appeared to influence the rate on ATN. Reperfusion injury or related effects may be responsible for the CVP drop. No influence of volume of fluids infused on occurrence of ATN |
| Tóth et al. [11] | 1998 | Deceased | Prospective | 121 | Correlation of hemodynamic data with nonfunctioning grafts vs delayed graft function vs good graft function | Good graft function group had higher MAP (108 ± 26 mmHg) |
| Thomsen et al. [8] | 1987 | Deceased and living (51 vs 10) | Prospective nonrandomized control | 61 (30 in group I, 31 in group II) | CVP not measured vs CVP kept > 5 cmH2O | Onset of graft function: Group I, 30%; Group II, 62% |
| Carlier et al. [10] | 1982 | Deceased | Prospective observational | 120 | Mean PAP ≤ 20 mmHg and diastolic PAP ≤ 15 mmHg vs mean PAP > 20 mmHg and DPAP > 15 mmHg | 36% of ATN in Group I vs only 6% in Group II |
ARE acute renal failure, ATN acute tubular necrosis, BP blood pressure, CVP central venous pressure, DGF delayed graft function, DPAP diastolic pulmonary artery pressure, MAP mean arterial pressure, PNF primary nonfunction, PAP pulmonary artery pressure, RVEDVI right ventricular end-diastolic pressure, SVV stroke volume variation, TED transesophageal Doppler