title: Regional versus general anesthesia for donor nephrectomy: effects on graft function.
abstract: Various general and regional anesthesia methods are used successfully in living-donor kidney transplantation. This study compared kidney graft function after general versus combined spinal-epidural anesthesia for donor nephrectomy. The study groups included recipients who received grafts from donors who had undergone nephrectomy under general anesthesia (GA group; n=10), and recipients who received grafts from donors who had combined spinal-epidural anesthesia (CSE group, n=10). Standard continuous epidural anesthesia was administered during all transplantations. Graft function was assessed using scintigraphy and Doppler ultrasonography on days 3 and 7. Urine levels of microalbumin, creatinine, and creatinine clearance rate were measured/calculated in 24-hour urine samples collected on postoperative days 3 and 7. There were no differences on either day 3 or day 7 with respect to glomerular filtration rate, microalbuminuria, or creatinine clearance rate (P >.05 for all). There were also no differences between the groups with respect to other scintigraphic findings on day 3 or day 7 (P >.05 for all). Ultrasonography on day 7 showed significantly higher mean peak systolic flow in the main renal artery in the CSE group than in the GA group (P=.035). The results suggest that GA and CSE for donor nephrectomy have similar effects on kidney graft function in recipients.
authors.affiliation: Baskent University Faculty of Medicine, Department of Anesthesiology, Dadaloglu mah, Adana, Turkey. msutsenertr@yahoo.co.utk
authors.forename: M
authors.initials: M
authors.lastname: Sener
authors.forename: A
authors.initials: A
authors.lastname: Torgay
authors.forename: E
authors.initials: E
authors.lastname: Akpek
authors.forename: T
authors.initials: T
authors.lastname: Colak
authors.forename: H
authors.initials: H
authors.lastname: Karakayali
authors.forename: G
authors.initials: G
authors.lastname: Arslan
authors.forename: M
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D000419:Albuminuria; D000765:Anesthesia, Conduction; D000768:Anesthesia, General; D003404:Creatinine / Q000378:metabolism; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D019520:Living Donors; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003404:Creatinine