Table 1.
The main characteristics of Randomized controlled trials (RCTs) included
| Study | Year | Study type | Donor type | No. of participants | Exclusion | Intervention | Outcome | Cointervention |
|---|---|---|---|---|---|---|---|---|
| O’Malley et al. [7] | 2005 | RCT | Living or deceased | 51 | <18 yr, belief preventing the use of blood products, K > 5.5 presurgery | RL (n = 25) vs. NSS (n = 26) | Serum Cr at postoperative day 3, Cr at day 7 and 6 mo, K and acid-base balance, urine output at 4 and 48 hr | Immunosuppression: steroids, calcineurin, and mycophenolate or sirolimus |
| Routine radial artery catheter and CV catheter discretional | ||||||||
| Hadimioglu et al. [8] | 2008 | RCT | Living | 90 | Severe CVD, liver failure, DM, K > 5.5 presurgery | RL (n = 30) vs. NSS (n = 30) vs. plasmalyte (n = 30) | Daily urine volume, serum Cr at day 3 after surgery, blood pH, bicarbonate, and K after surgery. Cr, BUN, chloride, urinary output, and Cr clearance at days 1, 2, 3, and 7 after surgery, serum K at the end of surgery, blood pH at the end of surgery | Immunosuppression: steroids, cyclosporine, and mycophenolate |
| Khajavi et al. [9] | 2008 | RCT | Living | 52 | Serum K > 6 presurgery | RL (n = 26) vs. NSS (n = 26) | Serum K at the end of surgery, blood pH at the end of surgery, Cr at day 3, urine output at 4 hr | Immunosuppression: steroids, cyclosporine, and mycophenolate |
| Heparin 5,000 IU IV | ||||||||
| Routine radial artery catheter and CV catheter | ||||||||
| Maintenance fluids for CVP of 10–15 mmHg | ||||||||
| Modi et al. [10] | 2012 | RCT | Living | 74 | Severe CVD, liver failure, DM, K > 5.5 presurgery | RL (n = 37) vs. NSS (n = 37) | Intraoperative and day 1 urine output, serum Cr day 1 after surgery, change in blood pH, intra- and postoperative bicarbonate and K | Immunosuppression: steroids |
| Mannitol, furosemide | ||||||||
| Maintain CVP 12–15 mmHg | ||||||||
| Kim et al. [11] | 2013 | RCT | Living | 60 | Severe CVD, severe respiratory disease | Plasmalyte (n = 30) vs. NSS (n = 30) | blood pH, PaCO2, bicarbonate, sodium, K, chloride lactate, phosphate, and albumin during surgery, serum chloride, Cr, and urine output on postoperative days 1, 2, and 7 | Immunosuppression: basiliximab, steroids, calcineurin inhibitor, and mycophenolate or mizoribine |
| Furosemide | ||||||||
| Maintain CVP 12–16 mmHg | ||||||||
| Potura et al. [12] | 2014 | RCT | Deceased | 150 | Age < 18 yr, serum K > 5.5 presurgery | Acetate buffered (n = 74) vs. NSS (n = 76) | Serum Cr, BUN, urine output on days 1, 3, 7, incidence of hyperkalemia, blood pH, standard BE, chloride, and K during surgery and postoperative surveillance | Immunosuppression: not mentioned |
| Calcium gluconate, insulin, and glucose for hyperkalemia with ECG changes | ||||||||
| Weinberg et al. [13] | 2017 | RCT | Deceased | 49 | Age < 18 yr, serum K > 6 presurgery CLD (AST/ALT > 1.5× normal) |
Plasmalyte (n = 24) vs. NSS (n = 25) | Hyperkalemia within 48 hr, hyperkalemia during hospital admission, treatment for hyperkalemia, the requirement for postoperative dialysis, delayed graft function, postoperative complications, and hospital length of stay | Immunosuppression: steroids, tacrolimus, mycophenolate, and basiliximab |
| Furosemide, insulin + glucose for hyperkalemia, no CVP used | ||||||||
| Fathi et al. [14] | 2018 | RCT | Living | 40 | Age < 18 or > 70 yr, advanced CVD, blood pH less than 7.15, temperature < 35°C and > 38.5°C presurgery Cancer or using immunomodulators |
Sodium bicarbonate (n = 20) vs. NSS (n = 20) | Acidosis (BE, HCO3-, PCO2, and blood pH), IL-2, IL-10, IFN -, BUN, urine volume, and Cr | Immunosuppression: not mentioned |
| Mannitol and Lasix | ||||||||
| Right IJ CVP 10–12 mmHg | ||||||||
| Radial artery catheter | ||||||||
| Arslantas et al. [15] | 2019 | Retrospective cohort study design | Living | 60 | Age < 17 or > 67 yr | Balanced crystalloids (n = 30) vs. NSS (n = 30) | Hyperchloremia and hyperkalemia within 24 hr after surgery, serum Cr at preoperative and within 5 days after transplantation, the incidence of acute rejection episodes, graft failure, length of stay at the hospital, and mortality | |
| Pourfakhr et al. [16] | 2020 | RCT | Deceased | 100 | K > 5.5 presurgery, COPD, CHF (EF < 30%), BE ≤ –15 mEq/L, bicarbonate ≤ 10 mEq/L, blood pH ≤ 7.15, CLD | Half saline bicarbonate (n = 50) vs. NSS (n = 50) | Cr at days 1, 3, 5, 7, urine output at 6 and 24 hr, BE, sodium, and chloride | Immunosuppression: antithymocyte, globulin infusion presurgery |
| Radial artery catheter | ||||||||
| IJ Catheter |
BE, base excess; BUN, blood urea nitrogen; CHF, congestive heart failure; CLD, chronic liver disease; COPD, chronic obstructive pulmonary disease; Cr, serum creatinine (mg/dL); CV, central venous; CVD, cardiovascular disease; CVP, central venous pressure; DM, diabetes mellitus; ECG, electrocardiography; EF, ejection fraction; IFN, interferon; IJ, internal jugular (vein); IL, interleukin; IV, intravenous; K, serum potassium (mEq/L); LFT, liver function test; NSS, normal saline solution; RL, Ringer’s lactate.