Effect of isoflurane versus propofol on the early outcome of living-donor adult kidney transplantation

Abstract

Background: Optimizing anesthetic management for the best possible outcome is essential in kidney transplantation (KT). 

Objective: To evaluate the difference in grafted kidney function and early kidney transplant outcome when the pairs of donor-recipient were anesthetized with isoflurane compared to propofol.

Material and Methods: Thirty-eight pairs of kidney transplant donor-recipient were anesthetized with isoflurane, and 22 pairs were anesthetized with propofol. Blood urea nitrogen (BUN), serum creatinine (SCr), estimated glomerular filtration rate (eGFR) were assessed in the preoperative period, on the first postoperative day, before discharge from the hospital, and then in 6 months after KT. Early outcomes (6 months) were evaluated with delayed graft function, acute rejection episodes, and graft failure.

Results: There was no statistically significant difference between the two groups in the serial measurements of SCr, BUN, eGFR, and the early outcomes (6 months) after the surgery. Interestingly, donor warm ischemic time in group propofol was significantly longer than in group isoflurane (P= 0.001). However, postoperative hospital stay in group propofol was significantly less than group isoflurane (P= 0.02).

Conclusion: There were no significant differences in transplanted kidney function and the early outcome of the kidney transplantation between the two study groups. However, earlier hospital discharge after the surgery in the propofol group suggests that propofol may be a more appropriate anesthetic choice in these patients.