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The prevention of renal impairment in patients undergoing orthotopic liver grafting by infusion of low dose dopamine
Author(s) -
POLSON R. J.,
PARK G. R.,
LINDOP M. J.,
FARMAN J. V.,
CALNE R.Y.,
WILLIAMS R.
Publication year - 1987
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1987.tb02938.x
Subject(s) - medicine , dopamine , transplantation , liver transplantation , surgery , creatinine , anesthesia , incidence (geometry) , orthotopic liver transplantation , renal function , physics , optics
Summary Administration of low dose dopamine (2.0 μg/kg/minute) begun before surgery in patients undergoing liver transplantation decreases the incidence of postoperative renal impairment. Thirty‐four consecutive patients in the Cambridge/King's College Hospital liver transplantation series were studied. Nineteen patients (21 transplant operations) received prophylactic low dose dopamine throughout the operative and early postoperative period, while 15 patients (15 transplant operations) received dopamine only when clinically indicated for incipient renal failure or as an inotropic agent. In the prophylactic dopamine group, only two transplant operations (9.5%) were complicated by renal impairment, whereas in the other group, 10 patients (67%) developed renal impairment (p = 0.001); of these, four developed acute renal failure (27%). Comparison of seven pairs of patients, matched for age, sex, diagnosis, operative blood loss and operative hypotension (one group receiving dopamine, the other not), revealed a significantly higher urine output in the first 24 hours and creatinine clearance 24—48 hours after surgery (p < 0.05) in those treated prophylactically. In view of these findings, we would recommend that consideration be given to the prophylactic use of dopamine in patients undergoing orthotopic liver transplantation.