title: Early Allograft Function in Renal Transplant Recipients: Is it Affected by Volatile Anesthetics?
abstract: BACKGROUND
  Different inhalational anesthetics have various hemodynamic effects, either on the global circulation or on renal perfusion. The purpose of the current retrospective, single-center study was to evaluate allograft function of renal transplant recipients after transplantation surgery under either sevoflurane or isoflurane anesthesia.
  
  
  METHODS
  From January 2004 through February 2014, a total of 240 patients undergoing renal transplantation were retrospectively enrolled in this study. The recipients were categorized into a sevoflurane or isoflurane group based on the type of volatile anesthetic used. The evaluated outcomes were serum urea and creatinine values and volume of diuresis at day 14 after transplantation.
  
  
  RESULTS
  There were no differences between the 2 anesthesia groups regarding age, gender, duration and etiology of end-stage renal disease, duration and type of dialysis regimen, and source of transplantation (living or cadaveric). Length of hospitalization was higher in the sevoflurane group when compared with the isoflurane group (21.64 ± 11.55 days vs 17.35 ± 8.06 days; P = .033). Similarly, the sevoflurane group had more postoperative complications then the isoflurane group. Although serum creatinine levels were similar between the 2 groups, the serum level of urea was higher (89.56 ± 47.60 mg/dL vs 76.85 ± 65.42 mg/dL; P = .038) and the volume of diuresis was lower (3718.00 ± 2558.94 mL/24 hours vs 4991.25 ± 2861.90 mL/24 hours; P = .042) in the sevoflurane group when compared with the isoflurane group.
  
  
  CONCLUSIONS
  Our data seem to suggest a potential role of isoflurane for improving allograft function and reducing complications more safely than sevoflurane as a volatile anesthetic in patients undergoing renal transplantation.
authors.affiliation: Department of Transplantation, Kartal Research and Training Hospital, Istanbul, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Yildirim
authors.affiliation: Department of Transplantation, Kartal Research and Training Hospital, Istanbul, Turkey.
authors.forename: H F
authors.initials: HF
authors.lastname: Kucuk
authors.affiliation: Department of Transplantation, Kartal Research and Training Hospital, Istanbul, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Demir
authors.affiliation: Department of Anesthesia, Kartal Research and Training Hospital, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Yakupoglu
authors.affiliation: Department of Nephrology, Kartal Research and Training Hospital, Istanbul, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Yavuz
authors.affiliation: Department of Nephrology, Kartal Research and Training Hospital, Istanbul, Turkey. Electronic address: elifaribakir@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Ari
mesh_terms: D000328:Adult; D064591:Allografts; D018685:Anesthetics, Inhalation; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007530:Isoflurane; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D012189:Retrospective Studies; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D003404:Creatinine; D007530:Isoflurane