title: Impact of 6% Starch 130/0.4 and 4% Gelatin Infusion on Kidney Function in Living-Donor Liver Transplantation.
abstract: BACKGROUND
  Since the first liver transplantation, pretransplantation or post-transplantation renal problems are still among the main causes of mortality and morbidity. The aim of this study was to evaluate the effects of fluid replacement solutions used intraoperatively on renal functions in elective living-donor liver transplantation.
  
  
  METHODS
  After Ethics Committee approval, informed consents were obtained from patients. Patients with normal renal functions and scheduled for elective living-donor-liver transplantation were included in the study. Patients were randomly allocated to infusion with 6% hydroxyehylstarch 130/40 (HES group) and 4% Gelofusine (GEL group). Blood samples were obtained before the induction of anesthesia (baseline), at the end of the operation, and postoperative days 1 and 4. Different estimated glomerular filtration rate (eGFR) formulas using creatinine (modification of renal disease, chronic kidney disease-epidemiology collaboration and Cockraud Gault) were used to calculate the eGFR.
  
  
  RESULTS
  Thirty-six patients were included in the study (GEL group = 18; HES group = 18). Patient characteristics, modified end stage liver disease-Child Pugh score, American Society of anaesthesiologist scores, and intraoperative data were similar between groups. Postoperative measurements showed that creatinine was significantly higher in the GEL group compared with the baseline, which was not the case for the HES group. Similarly, postoperative eGFR levels, as measured using MDRD and CKD-EPI, were found to be significantly lower in the GEL group. Postoperative urine albumin:creatinine ratios were significantly higher in the GEL group compared with baseline. Total crystalloid amount used, colloid, blood, fresh frozen plasma values, extubation, and intensive care unit (ICU) and hospital stay were similar in both groups. Postreperfusion syndrome developed in 6 patients in each group.
  
  
  CONCLUSIONS
  In conclusion, Gelofusine seem to cause more impairment in renal functions in elective living-donor liver transplantation.
authors: Department of Anesthesia, Türkiye Yüksek İhtisas Education and Research Hospital, Ankara, Turkey.
authors: A
authors: A
authors: Demir
authors: Department of Anesthesia, Türkiye Yüksek İhtisas Education and Research Hospital, Ankara, Turkey. Electronic address: drbahar2003@yahoo.com.
authors: B
authors: B
authors: Aydınlı
authors: Department of Anesthesiology, Inonu University Faculty of Medicine, Malatya, Turkey.
authors: H I
authors: HI
authors: Toprak
authors: Department of Anesthesia, Türkiye Yüksek İhtisas Education and Research Hospital, Ankara, Turkey.
authors: Ü
authors: Ü
authors: Karadeniz
authors: Department of Biochemistry, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors: F M
authors: FM
authors: Yılmaz
authors: Department of Biochemistry, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors: C
authors: C
authors: Züngün
authors: Department of Anesthesia, Türkiye Yüksek İhtisas Education and Research Hospital, Ankara, Turkey.
authors: P
authors: P
authors: Uçar
authors: Department of Anesthesia, Türkiye Yüksek İhtisas Education and Research Hospital, Ankara, Turkey.
authors: Ç Y
authors: ÇY
authors: Güçlü
authors: Department of Gastroenterological Surgery, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
authors: E B
authors: EB
authors: Bostancı
authors: Department of Surgery, Division of Liver Transplantation, Inonu University Faculty of Medicine, Malatya, Turkey.
authors: S
authors: S
authors: Yılmaz
mesh_terms: D000328:Adult; D003404:Creatinine / Q000097:blood; D005260:Female; D005780:Gelatin / Q000008:administration & dosage*; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives; D007262:Infusions, Intravenous; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000503:physiopathology; D013213:Starch / Q000008:administration & dosage*
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D005780:Gelatin; D013213:Starch; D003404:Creatinine