Comparison between the effects of intraoperative human albumin and normal saline on early graft function in renal transplantation

Abstract

Purpose: The aim of the current study was to compare the effects of intraoperative infusion of 20 % human albumin versus 0.9 % normal saline on early and late graft function in renal transplantation.

Methods: This prospective, randomized study was conducted on 44 patients with end-stage renal disease undergoing kidney transplantation. Patients were 32 males (72.7 %) and 12 females (27.3 %) with a mean age of 54.35 ± 11.15 years (range 20-58 years). Patients with cardiac disease and liver dysfunction were excluded from the study. Twenty-two of the 44 patients were given intraoperative intravenous infusion of 20 % human albumin with 0.9 % normal saline (albumin group), and the remaining 22 patients received intraoperative intravenous infusion of 0.9 % normal saline alone (saline group), as part of the intraoperative fluid hydration to keep central venous pressure between 10 and 15 mm of Hg.

Results: There was no statistically significant difference in mean intravenous fluid volume infused until the end of surgery between the saline group and the albumin group (P = 0.8326). Time of onset of diuresis and total intraoperative urine output were statistically insignificant between the two groups (P = 0.6255, P = 0.9231, respectively). Post-transplant serum creatinine on day 1, 3 and 5 between the albumin and saline groups were comparable (P = 0.8998, P = 0.7257, P = 0.8092, respectively). Post-transplant urine output on day 1, 3 and 5 between the albumin and saline groups were also comparable (P = 0.653, P = 0.9075, P = 0.946, respectively). Mean postoperative weight gain was higher in the saline group compared with the albumin group, but was not statistically significant (P = 0.6348).

Conclusions: This study revealed that the use of 20 % human albumin as an intraoperative volume expander provides no more benefit than the use of 0.9 % normal saline in terms of immediate graft function in living donor renal transplantation.