Normal Saline vs Plasma-Lyte A Use Intra- and Post-Operatively in Adult Kidney Transplant Recipients

Abstract

Fluid management intra- and post-operatively for kidney transplant recipients (KTR) is essential to maintain adequate perfusion to the kidney. 0.9% normal saline (NS) is commonly used, but it can cause hyperchloremic metabolic acidosis, which may result in hyperkalemia and lead to delayed graft function (DGF). Plasma-Lyte A (PA) is an alternative option that has a lower amount of chloride and a neutral pH, which may offset the risk of hyperkalemia. The aim of this study is to determine the incidence of DGF in KTRs comparing NS vs PA use intra- and initially post-operatively. This single-center, retrospective cohort study in adult KTRs from January 1, 2016 to February 1, 2021 consisted of two cohorts, those receiving NS vs PA. Multi-organ transplant recipients were excluded. The primary outcome was the incidence of DGF. A total of 244 KTRs in the NS group and 263 KTRs in the PA group were included. There was no significant difference in incidence of DGF between the groups, (NS 23.4% vs PA 25.9%, p = 0.537). The logistic regression for only deceased donors were not significantly different (OR 1.369 (0.819-2.288). There was no difference in the incidence of DGF when comparing NS vs PA.