Effects of Reduced Total Intraoperative Fluid Intake plus Rapid Normal Saline Infusion upon Vascular Anastomosis on Graft Function and Acid/Base Status in Kidney Transplant Surgery

Infusion of large volumes of normal saline is recommended for facilitating graft function during kidney transplantation surgery but it can cause severe metabolic acidosis. Here we studied the effects of intraoperative rapid normal saline infusion on vascular anastomosis، acid base، electrolytes and graft function.

In this study 30 patients were evaluated during kidney transplantation. Infusion of normal saline was started and increased from 10 ml/kg/h to 50 ml/kg/h during vessel anastomosis. Acid base balance electrolytes and anion gap measured at the beginning and end of surgery serum creatinine and urine output was measured up to 48 hours after surgery. Data analyzed was performed by statistical method.

Serum creatinine at 24 and 48 hours after surgery were 3. 04 ± 1. 59 and 2. 22 ± 1. 53 mg/dl respectively. PH change during the surgery was not significant (p=0. 818) but serum chloride increased from 94. 23 ± 3. 95 to 99. 37 ± 3. 84 (P< 0. 001). Base excess and anion gap decreased respectively from -3. 55 ± 3. 47 to -8. 40 ± 2. 65 (P<0. 001) and from 30. 46 ± 7. 72 to 26. 15 ± 8. 25 (P=0. 023) respectively.

Rapid infusion of normal saline to vessel anastomosis during the kidney transplantation is a risk for development of metabolic acidosis while it has beneficial effects on graft function.