Influence of alprostadil on the dynamics of blood flow resistance index and renal graft function in the early postoperative period
Aim. To evaluate the effect of continuous intravenous infusion of alprostadil solution on the dynamics of the peripheral resistance to arterial blood flow and renal graft function in the early postoperative period.Material and methods. From June 2018 to May 2022, 278 kidney transplants from a deceas...
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N.V. Sklifosovsky Research Institute for Emergency Medicine of Moscow Healthcare Department
2022-12-01
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| Series: | Трансплантология (Москва) |
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| Online Access: | https://www.jtransplantologiya.ru/jour/article/view/707 |
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| author | P. A. Drozdov I. V. Nesterenko D. A. Makeev O. S. Zhuravel S. A. Astapovich D. A. Solomatin E. A. Lidzhieva |
| author_facet | P. A. Drozdov I. V. Nesterenko D. A. Makeev O. S. Zhuravel S. A. Astapovich D. A. Solomatin E. A. Lidzhieva |
| author_sort | P. A. Drozdov |
| collection | DOAJ |
| description | Aim. To evaluate the effect of continuous intravenous infusion of alprostadil solution on the dynamics of the peripheral resistance to arterial blood flow and renal graft function in the early postoperative period.Material and methods. From June 2018 to May 2022, 278 kidney transplants from a deceased donor were performed at the City Clinical Hospital n.a. S.P. Botkin. In 179 recipients operated from June 2018 to May 2021, we evaluated the significance of the intraoperatively determined resistance index of blood flow in the segmental arteries of the renal graft as a predictor of the development of its delayed function. The study of the effect of alprostadil included 32 patients divided into 2 groups comparable in patient age, gender, body mass index. The resistance index in both groups was more than 0.85. In the second group patients received a continuous intravenous infusion of alprostadil solution in the first 3 days after surgery.Results. Retrospectively we found that in patients with a high resistance index (more than 0.85), the risk of developing delayed graft function was 6.9 times higher, that was statistically significant (p=0.001). In the alprostadil group, a delayed graft function developed in 5 of 18 patients (27.8%), compared with the control group, where delayed graft function developed in 9 of 14 (64.3%) patients, however, without reaching the level of statistical significance (p=0.072). The median time to normalization of graft function in group II was 4 (interquartile range: 3–4) days, while in group I it was 7 (interquartile range: 5–8) days (p=0.05). The median hospital length of stay in the alprostadil group was significantly lower than in the control group and amounted to 13 (interquartile range: 8–15) versus 17 (interquartile range: 15–19) days (p=0.032).Conclusion. The use of continuous intravenous infusion of alprostadil solution after kidney transplantation in patients with a high intraoperative resistance index can safely and effectively lead to a decrease in resistance index to normal rates, accelerate the recovery of graft function and significantly reduce the incidence of delayed graft function. However, further research is needed. |
| format | Article |
| id | doaj-art-a44b648b15454720bb365ee2c799a45a |
| institution | DOAJ |
| issn | 2074-0506 2542-0909 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | N.V. Sklifosovsky Research Institute for Emergency Medicine of Moscow Healthcare Department |
| record_format | Article |
| series | Трансплантология (Москва) |
| spelling | doaj-art-a44b648b15454720bb365ee2c799a45a2025-08-20T02:55:44ZengN.V. Sklifosovsky Research Institute for Emergency Medicine of Moscow Healthcare DepartmentТрансплантология (Москва)2074-05062542-09092022-12-0114445246110.23873/2074-0506-2022-14-4-452-461541Influence of alprostadil on the dynamics of blood flow resistance index and renal graft function in the early postoperative periodP. A. Drozdov0I. V. Nesterenko1D. A. Makeev2O. S. Zhuravel3S. A. Astapovich4D. A. Solomatin5E. A. Lidzhieva6City Clinical Hospital n.a. S.P. BotkinCity Clinical Hospital n.a. S.P. BotkinCity Clinical Hospital n.a. S.P. BotkinCity Clinical Hospital n.a. S.P. Botkin; Russian Medical Academy of Continuous Professional EducationCity Clinical Hospital n.a. S.P. BotkinI.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)Aim. To evaluate the effect of continuous intravenous infusion of alprostadil solution on the dynamics of the peripheral resistance to arterial blood flow and renal graft function in the early postoperative period.Material and methods. From June 2018 to May 2022, 278 kidney transplants from a deceased donor were performed at the City Clinical Hospital n.a. S.P. Botkin. In 179 recipients operated from June 2018 to May 2021, we evaluated the significance of the intraoperatively determined resistance index of blood flow in the segmental arteries of the renal graft as a predictor of the development of its delayed function. The study of the effect of alprostadil included 32 patients divided into 2 groups comparable in patient age, gender, body mass index. The resistance index in both groups was more than 0.85. In the second group patients received a continuous intravenous infusion of alprostadil solution in the first 3 days after surgery.Results. Retrospectively we found that in patients with a high resistance index (more than 0.85), the risk of developing delayed graft function was 6.9 times higher, that was statistically significant (p=0.001). In the alprostadil group, a delayed graft function developed in 5 of 18 patients (27.8%), compared with the control group, where delayed graft function developed in 9 of 14 (64.3%) patients, however, without reaching the level of statistical significance (p=0.072). The median time to normalization of graft function in group II was 4 (interquartile range: 3–4) days, while in group I it was 7 (interquartile range: 5–8) days (p=0.05). The median hospital length of stay in the alprostadil group was significantly lower than in the control group and amounted to 13 (interquartile range: 8–15) versus 17 (interquartile range: 15–19) days (p=0.032).Conclusion. The use of continuous intravenous infusion of alprostadil solution after kidney transplantation in patients with a high intraoperative resistance index can safely and effectively lead to a decrease in resistance index to normal rates, accelerate the recovery of graft function and significantly reduce the incidence of delayed graft function. However, further research is needed.https://www.jtransplantologiya.ru/jour/article/view/707kidney transplantationdelayed renal graft functionresistance indexalprostadil |
| spellingShingle | P. A. Drozdov I. V. Nesterenko D. A. Makeev O. S. Zhuravel S. A. Astapovich D. A. Solomatin E. A. Lidzhieva Influence of alprostadil on the dynamics of blood flow resistance index and renal graft function in the early postoperative period Трансплантология (Москва) kidney transplantation delayed renal graft function resistance index alprostadil |
| title | Influence of alprostadil on the dynamics of blood flow resistance index and renal graft function in the early postoperative period |
| title_full | Influence of alprostadil on the dynamics of blood flow resistance index and renal graft function in the early postoperative period |
| title_fullStr | Influence of alprostadil on the dynamics of blood flow resistance index and renal graft function in the early postoperative period |
| title_full_unstemmed | Influence of alprostadil on the dynamics of blood flow resistance index and renal graft function in the early postoperative period |
| title_short | Influence of alprostadil on the dynamics of blood flow resistance index and renal graft function in the early postoperative period |
| title_sort | influence of alprostadil on the dynamics of blood flow resistance index and renal graft function in the early postoperative period |
| topic | kidney transplantation delayed renal graft function resistance index alprostadil |
| url | https://www.jtransplantologiya.ru/jour/article/view/707 |
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