Calcium-channel blockers and other factors influencing delayed function in renal allografts.
A retrospective analysis was undertaken to examine the influence of calcium-channel blocking drugs on early renal allograft function. Delayed function was defined as the need for dialysis or a reduction in serum creatinine of less than 15% within 4 days of transplantation. The drug histories of 172 patients were examined. After exclusions, the data from 138 patients were analysed. No patient was taking any calcium-channel blocking drug other than nifedipine. Thirty-one patients were taking nifedipine at the time of transplantation and these had a delayed function rate of 16% compared with 40% for 107 patients not taking nifedipine (chi 2, P less than 0.05). Delayed function occurred in 61% of cases when the donor age was over 50 years compared with 29% with younger donors (chi 2, P less than 0.05). A total ischaemic time of longer than 24 h and administration of inotropic support to the donor were associated with delayed function (chi 2, P less than 0.05). Administration to the donor of mannitol, steroids, phenoxybenzamine and heparin had no effect on the rate of delayed function. Recipients treated with low-dose dopamine in the perioperative period had no advantage. Elevated trough whole blood concentrations of cyclosporin in the first week after transplant were associated with delayed function (Mann-Whitney U, P less than 0.05).
Ferguson
C J
CJ
Department of Surgery, Royal Infirmary, Cardiff, Wales, UK.
Hillis
A N
AN
Williams
J D
JD
Griffin
P J
PJ
Salaman
J R
JR
D000328:Adult; D002121:Calcium Channel Blockers / Q000494:pharmacology*; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation / Q000502:physiology*; D009543:Nifedipine / Q000494:pharmacology*; D015427:Reperfusion Injury / Q000517:prevention & control*; D012189:Retrospective Studies
D002121:Calcium Channel Blockers; D009543:Nifedipine