Changes in the Gasometric and Hemodynamic Profile upon Graft Reperfusion in Living Donor Kidney Transplant Patients

Abstract

Introduction: In the field of medicine, the study of hemodynamics is fundamental to understanding the functioning of the cardiovascular system and its impact on tissue oxygenation. Within this context, crucial parameters such as mean systemic filling pressure (MSFP), cardiac output (CO) and oxygen extraction rate (EO2) play essential roles in regulating tissue perfusion and oxygen delivery to the lungs the vital organs. In the case of kidney transplant recipient patients, the interaction between these parameters acquires unique relevance, given the intimate relationship between cardiovascular function and the new implanted kidney. Material And Methods: Material And Methods: A descriptive, observational, single-center, and retrospective study was carried out undergoing living donor kidney transplant patients between June 2022-2023 at the Hospital Juarez de Mexico. Results: 54 patient records were examined, 24 with exclusion criteria. Remaining 30, 18 were female (60%) and 12 were male (40%); Receiver: Age 30.46±11.68 years; Weight: 59.93±11.87kg; Size: 156.20±18.74cm; Hemoglobin: 9.87±1.62g/dl. Prior hemodynamic values to reperfusion: CaO2 (arterial content) 13.44 ± 2.22, CvO2 (venous content) 9.07 ± 2.20, Da-vO2 (arterio-venous difference) 3.67 ± 1.48, CO (cardiac output) 5.65 ± 3.13, VS ( stroke volume) 76.05±41.73, SVR(systemic vascular resistance) 852.61±396.72, DO2(oxygen delivery) 770.89±444.07, VO2(oxygen consumption) 239.33±29.38, EO2(oxygen extraction) 26.83±9.82, PMSF (mean systemic filling pressure) 17.47±3.09 mm Hg with Student's T con values of p<0.05 statistically significant; Hemodynamic values after reperfusion: CaO2 13.3±2.18, CvO2 8.11±1.61, Da-vO2 5.03±1.04, CO 4.57±1.26, VS 62.32±17.41, SVR 1265.97±419.41, DO2 621.66±150.83, VO2 239.33±29.38, EO2 37.62 ±5.28, PMSF 14.27±2.44 mm Hg with Student's T statistically significant values of p<0.05. Conclusions: Undergoing kidney transplantation patients strategies that include the optimization of PMSF, CO and EO2 based on their determinants can be implemented to improve perfusion and oxygenation of kidney transplanted prior kidney graft reperfusion, which in turn contributes to longterm viability and improved quality of life for the transplant recipient.