Effect of dexmedetomidine on renal function in pediatric patients undergoing living donor liver transplantation

Abstract

Objective To evaluate the effect of dexmedetomidine on renal function in pediatric patients undergoing living donor liver transplantation. Methods Sixty pediatric patients of both sexes with congenital biliary atresia, aged 5-15 months, weighing 5.5-10.0 kg, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective living donor liver transplantation, were randomly divided into either control group(group C)or dexmedetomidine group(group D)with 30 patients in each group.The infants were tracheally or nasotracheally intubated and mechanically ventilated after induction of anesthesia.Dexmedetomidine was intravenously infused in a loading dose of 1 μg/kg for 10 min, followed by a continuous infusion of 0.3 μg·kg-1·h-1 until the end of operation in group D. While the equal volume of normal saline was given instead of dexmedetomidine in group C. At skin incision (T1), at 30 min of anhepatic phase (T2), at 1 h of neohepatic phase (T3), immediately after peritoneum closure (T4) and at 24 h after operation (T5), blood samples from the central vein and urine specimens were collected for determination of creatinine and blood urea nitrogen (BUN) concentrations in serum (by colorimetric assay) and β2-microglobulin (β2-MG) concentrations in serum and urine (using immunoturbidimetric method), and concentrations of tumor necrosis factor-α, interleukin-6 (IL-6) and IL-18 in serum (by enzyme-linked immunosorbent assay). The urine volume was recorded during surgery. Results Compared with group C, the urine volume was significantly increased, and the serum creatinine, BUN and β2-MG concentrations and urine β2-MG concentrations at T3-5, serum BUN concentrations at T4, 5, and serum tumor necrosis factor-α, IL-6 and IL-18 concentrations at T2-5 were decreased in group D (P<0.05). Conclusion Dexmedetomidine can improve renal function in pediatric patients undergoing living donor liver transplantation. Key words: Dexmedetomidine; Liver transplantation; Kidney