Perioperative intravascular hemodynamics

The effect of delayed function on outcome is significant. For instance, graft survival at 1 year may be up to 25 per cent worse in patients with delayed function, with a mortality exceeding 10 per cent. Patients with diminished plasma and blood volume are more likely to have delayed onset of urine output. The loss of intravascular albumin during a renal transplant (approximately 1 g/kg body weight) corresponds to about 18 ml/kg body weight, or about 1200 ml of plasma volume in a 70-kg man

(Dawi,d.son„,and,Ar:Rajab 1992). Maintaining blood and plasma volume results in earlier and better post-transplant renal function. An important intraoperative factor affecting post-transplant function in cadaver renal transplant recipients is the maintenance of intravascular volume by administration of a colloid such as albumin in a dose of 1.0 to 1.5 g/kg, in addition to about 30 ml/kg of electrolyte solution ( Table,,,!).

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Table 1 Beneficial effects of the intraoperative administration of albumin in a dose of 1.2 to 1.5 g/kg in 437 cadaver renal transplants

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