Effects of applying ulinastatin in donors and recipients on the renal function of recipients in the living donor renal transplantation and the mechanism of renal protection

Abstract

Objective To investigate the effects of ulinastatin(UTI) on renal function and the mechanism of renal protection, when using UTI in donors and recipients in living donor renal transplantation. Methods Forty pairs of patients were randomly assigned into two groups: the ulinastatin group(group U) and the control group(group C). One hour before blocking renal artery, the donors in group U were given ulinastatin 500 U/kg (dissolved in 50 ml saline) for 20 min by intravenous pump, when the renal blood vessels opening, the recipients in group U were infused ulinastatin 500 U/kg (dissolved in 50 ml saline) for 20 min. The donors and recipients in group C received 50 ml saline solution in the same way. The serum thromboxane B2(TXB2), 6-ketone-prostaglandin F1α(6-keto-PGF1α) levels and the TXB2/6-keto-PGF1α were compared before anesthesia induction(T1), 15 min before vessels opening(T2), vessels opening immediately(T3), the end of the operation(T4), 6 h after surgery (T5), 24 h after surgery (T6) in two groups. The serum creatinine(Scr) and cystatin C(CysC) levels were detected and urine volume was recorded at T1, T6 and 48 h after surgery (T7). Results Compared with T1, the serum TXB2 levels in two group were significantly increased at the time points of T2-T6(P 0.05). Conclusions UTI can protect renal function during related donor kidney transplantation, which is related to effectively correct the TXA2/PGI2 proportional unbalance to improve renal blood perfusion. Key words: Living donor renal transplantation; Ulinastatin; Thromboxane A2; Prostacyclin I2; Ischemia/reperfusion injury