PD45-12 INTRAOPERATIVE MANNITOL ADMINISTRATION DURING LAPAROSCOPIC DONOR NEPHRECTOMY AND IMPACT ON LONG-TERM GRAFT FUNCTION

Abstract

You have accessJournal of UrologyRenal Transplantation & Vascular Surgery II (PD45)1 Sep 2021PD45-12 INTRAOPERATIVE MANNITOL ADMINISTRATION DURING LAPAROSCOPIC DONOR NEPHRECTOMY AND IMPACT ON LONG-TERM GRAFT FUNCTION Gustavo Gryzinski, Jason Farrow, Clinton Bahler, and Chandru Sundaram Gustavo GryzinskiGustavo Gryzinski More articles by this author , Jason FarrowJason Farrow More articles by this author , Clinton BahlerClinton Bahler More articles by this author , and Chandru SundaramChandru Sundaram More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002059.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: End-stage renal disease frequently results in dialysis, and at best, transplantation. Laparoscopic donor nephrectomy was introduced in 1995 and has been a valuable source of high-quality organs. Improving long-term graft function of recipients through judicious intraoperative medical management remains an essential goal. Infusion of mannitol prior to hilar clamping during donor nephrectomy has been utilized based on its proposed cytoprotective properties – theoretically improving renal perfusion, free-radical scavenging, and diuresis. However, there is a paucity of large, long-term studies evaluating its use. In this study, we aimed to explore the long-term effects of intraoperative mannitol administration on graft function as measured by creatinine. METHODS: A single-center, retrospective analysis of a contemporary cohort of donor nephrectomies was performed. Eighty donors (sample determined using a power of 0.8 to detect a 20% difference in creatinine) were identified and then matched to recipients using Indiana University’s Organ Transplant Tracking Record database. Patients were balanced by sex and stratified by intraoperative administration of mannitol (yes vs no). Creatinine was recorded at fixed intervals per routine nephrology follow-up. Statistical analysis was performed using SPSS. RESULTS: Basic demographics are presented in Table 1. The only significant difference in baseline clinical factors was donor intraoperative diuretic administration, which was more frequently co-administered with mannitol. Creatinine means by time can be seen in Figure 1. Multiple means comparisons were made using ANOVA and did not reveal any differences in creatinine at three years post-transplant (p > 0.05). CONCLUSIONS: Mannitol administration did not statistically affect post-transplant creatinine up to the three-year follow-up. On post-hoc analysis, elimination of cases where diuretics were co-administered did not change these results. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e746-e747 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gustavo Gryzinski More articles by this author Jason Farrow More articles by this author Clinton Bahler More articles by this author Chandru Sundaram More articles by this author Expand All Advertisement Loading ...