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BJA Advance Access published online on February 6, 2008
British Journal of Anaesthesia, doi:10.1093/bja/aen001
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Comparison of the novel hydroxyethylstarch 130/0.4 and hydroxyethylstarch 200/0.6 in brain-dead donor resuscitation on renal function after transplantation

V. Blasco1,2, M. Leone1,2,*, F. Antonini1,2, A. Geissler1,2, J. Albanèse1,2 and C. Martin1,2

1 Département d'Anesthésie et de Réanimation, CHU Nord, Assistance Publique-Hôpitaux de Marseille, 13915 Marseille Cedex 20, France
2 Université de la Méditerranée, 13005 Marseille, France

* Corresponding author. Département d'Anesthésie et de Réanimation, CHU Nord, Assistance Publique-Hôpitaux de Marseille, 13915 Marseille Cedex 20, France. E-mail: marc.leone{at}ap-hm.fr

Background: The renal effect of hydroxyethylstarch (HES) solutions remains controversial. We hypothesized that the use of HES with a mean molecular weight of 130 kDa would reduce renal dysfunctions in the recipients. Our study was aimed at comparing the effects of two fluid regimens (HES 130/0.4 or HES 200/0.6) used for the resuscitation of brain-dead donors on the rate of delayed graft function (DGF) and the serum creatinine levels post-transplantation.

Methods: This retrospective matched-paired study was conducted in an intensive care unit of a university hospital. Case–controls were matched at the donor patient level as follows: gender, BMI, duration of ICU stay, serum creatinine levels, vasopressor, and volume of colloids. The organ donation from 64 brain-dead donors resulted in 115 transplants.

Results: The renal function was similar among all donors. The characteristics of the recipients, including the cold ischaemia time, were similar. The rate of DGF was 22% in the donors treated with HES 130/0.4, compared with 33% in those treated with HES 200/0.6 (P=0.27). The serum creatinine levels at 1 month were 133 (38) µmol litre–1 when the donors had been treated with HES 130/0.4 and 172 (83) µmol litre–1 when they were treated with HES 200/0.6 (P=0.005). A difference was found 1 yr after transplantation [128 (36) vs147 (43) µmol litre–1, P=0.05].

Conclusions: Using a modern, third-generation, rapidly degradable HES preparation with a low degree of substitution seems to be associated with a better effect on the renal function of recipients.

Keywords: fluids, i.v.; head, injury; kidney, failure; kidney, transplantation


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Home page
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F. M. Brunkhorst, M. Oppert, M. Leone, V. Blasco, J. Albanese, and C. Martin
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