title: The influence of intraoperative central venous pressure on delayed graft function in renal transplantation: a single-center experience.
abstract: BACKGROUND
  Delayed graft function (DGF) is a common complication in kidney transplantation. We sought to evaluate possible correlates for DGF including intraoperative parameters, focusing on fluid replacement and central venous pressure (CVP) values among patients undergoing kidney transplantation at our center.
  
  
  METHODS
  One hundred fifty-five cadaveric donor transplantations performed at our center between 2001 and 2005 were selected for the study. We compared intraoperative parameters together with 15 other clinical and socio-demographic recipient and donor variables among patients experiencing DGF (n = 58) versus those with immediate graft function (IGF; n = 97). All significant variables at P < .05 upon univariate analysis were entered into a multivariate logistic regression model to identify risk factors for DGF.
  
  
  RESULTS
  CVP at awakening of ≤8 mm Hg (odds ratio [OR] = 3.53; 95% confidence interval [CI], 1.63-7.63), fluid input during surgery ≤2.250 mL (OR = 2.12; 95% CI, 1.00-4.51), and recipient age ≥50 years (OR = 2.72; 95% CI, 1.11-6.68) were the strongest correlates of DGF.
  
  
  CONCLUSIONS
  Our data suggested that reduced intraoperative perfusion as measured using CVP monitoring might increase DGF risk. This study provides the rationale to further investigate the optimal CVP target during this surgery.
authors.affiliation: Department of Internal Medicine, Aging and Renal Disease, University of Bologna, Bologna, Italy. giuliana.bacchi@unibo.it
authors.forename: G
authors.initials: G
authors.lastname: Bacchi
authors.forename: A
authors.initials: A
authors.lastname: Buscaroli
authors.forename: M
authors.initials: M
authors.lastname: Fusari
authors.forename: L
authors.initials: L
authors.lastname: Neri
authors.forename: M L
authors.initials: ML
authors.lastname: Cappuccilli
authors.forename: E
authors.initials: E
authors.lastname: Carretta
authors.forename: S
authors.initials: S
authors.lastname: Stefoni
mesh_terms: D000328:Adult; D001795:Blood Pressure Determination; D016022:Case-Control Studies; D002496:Central Venous Pressure; D000077324:Crystalloid Solutions; D051799:Delayed Graft Function / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage; D007558:Italy; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D016017:Odds Ratio; D010952:Plasma Substitutes / Q000008:administration & dosage; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes