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Effect of dexmedetomidine on the incidence of postoperative acute kidney injury in living donor liver transplantation recipients: A randomized controlled trial.

ABSTRACT:

Background

Acute kidney injury (AKI) is one of the most common complications after living-donor liver transplantation (LDLT) that has great impact on recipient and graft outcomes. Dexmedetomidine is reported to decrease the incidence of AKI. In the current study, we investigated whether intraoperative dexmedetomidine infusion would reduce the AKI following LDLT.

Material and methods

In total, 205 adult patients undergoing elective LDLT were randomly assigned to the dexmedetomidine group (n=103) or the control group (n=102). Dexmedetomidine group received continuous dexmedetomidine infusion at a rate of 0.4 mcgּ/kg/hr after the anesthesia induction until 2 hours after graft reperfusion. The primary outcome was to compare the incidence of AKI. Secondary outcomes included serial lactate levels during surgery, chronic kidney disease, major adverse cardiovascular events, early allograft dysfunction, graft failure, overall mortality, duration of mechanical ventilation, ICU and hospital length of stay. Intraoperative hemodynamic parameters were also collected.

Results

Of 205 recipients, 42.4% (n=87) developed AKI. The incidence of AKI was lower in the dexmedetomidine group (35.0%, n=36/103) compared with the control (50.0%, n=51/102) ( P =0.042). There were significantly lower lactate levels in the dexmedetomidine group after reperfusion (4.39 [3.99-4.8] vs 5.02 [4.62-5.42], P =0.031) until the end of surgery (4.23 [3.73-4.73] vs 5.35 [4.84-5.85], P =0.002). There were no significant differences in the other secondary outcomes besides lactate. Also, intraoperative mean blood pressure, cardiac output, and systemic vascular resistance did not show any difference.

Conclusion

Our study suggests that intraoperative dexmedetomidine administration was associated with significantly decreased AKI incidence and lower intraoperative serum lactate levels in LDLT recipients, without untoward hemodynamic effects.

SUBMITTER: Kwon HM

PROVIDER: S-EPMC11254204 | biostudies-literature | 2024 Mar

REPOSITORIES: biostudies-literature

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Effect of dexmedetomidine on the incidence of postoperative acute kidney injury in living donor liver transplantation recipients: a randomized controlled trial.

Kwon Hye-Mee HM Kang Sa-Jin SJ Han Sang-Bin SB Kim Jae Hwan JH Kim Sung-Hoon SH Jun In-Gu IG Song Jun-Gol JG Hwang Gyu-Sam GS

International journal of surgery (London, England) 20240701 7

<h4>Background</h4>Acute kidney injury (AKI) is one of the most common complications after living-donor liver transplantation (LDLT) that has great impact on recipient and graft outcomes. Dexmedetomidine is reported to decrease the incidence of AKI. In the current study, the authors investigated whether intraoperative dexmedetomidine infusion would reduce the AKI following LDLT.<h4>Material and methods</h4>In total, 205 adult patients undergoing elective LDLT were randomly assigned to the dexmed ...[more]

PMID: 38537086

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