Volatile Anesthetic Protection Of Renal Transplants 2

DGF is defined as need of dialysis first 7 days after transplantation Acute rejection up to 1 year after transplantation, defined by the modified BANFF 2013 classification and must be associated with decline in kidney function and treatment.

calculated with the CKD-EPI formula

PNF is defined as permanent lack of function of the transplanted kidney. This kidney will not gain function after transplantation

Absence of a daily decrease of at least 10% in serum creatinine for at least three consecutive days

Days

Mortality due to any cause

In a subpopulation of Groningen, Aarhus, Oslo; employing Iodinethalamate (Groningen), CrEDTA (Aarhus) and Iohexol (Oslo)

The aim of our study is to investigate cardiac biomarkers in kidney transplant recipients using two different anesthesia regimen and to investigate whether there is any difference in outcome. In this substudy we will investigate the levels and thresholds of cardiac biomarkers (Troponin-T and pro-BNP) at three time points (day 0, day 1 and day3) with two different anesthetic management (intravenous or inhalational), and the impact of outcome and MACE (major adverse cardiac events). The findings in this study may provide important information for the transplant team about which anesthesia is best suited for kidney transplant recipients with cardiovascular comorbidity.

The donation and transplantation procedure is inevitably accompanied by harmful processes that impact the kidney's viability. Ischemia reperfusion injury (IRI) is one of the main harmful processes which frequently results in complications and reduced kidney function after transplantation, such as delayed graft function (DGF) or primary non-function (PNF) . It is therefore important to detect and prevent damage as a result of IRI. An improved and earlier detection of IRI-induced damage might allow therapeutic measures and improve renal function and patient outcome on a longer term. We studied several biomarkers in a living donor kidney transplantation (LDKT) cohort. We will now proceed whit analysis of the release pattern and predictive value of KIM-1, H-FABP, NAG and NGAL and novel biomarkers on short- and long-term graft outcome after deceased donor kidney transplantation

Perioperative hemodynamic and fluid management remains one of the most debated topics in modern anesthesia, particularly in the context of kidney transplantation, where there is currently no consensus on optimal blood pressure targets. This is further complicated by the fact that the transplanted kidney is denervated, resulting in impaired autoregulation and making renal blood flow directly dependent on systemic circulation. Our objective is to identify specific intraoperative hemodynamic parameters that are associated with both short- and long-term graft outcomes. To achieve this, we will analyze continuous intraoperative hemodynamic data and assess their relationship with delayed graft function (DGF), acute rejection (AR), primary non-function (PNF), estimated glomerular filtration rate (eGFR) at 3 and 12 months, and overall graft survival.

This substudy investigates the incidence of postoperative delirium after renal transplantation in a randomized controlled trial with two groups anesthetized using either Propofol or Sevoflurane. Postoperative delirium will be screened using RASS (Richmond agitation sedation score) in the PACU and CAM (Confusion assessment method) during the first two postoperative days on the ward.

The findings from this study will provide information about the incidence of postoperative delirium following renal transplantation. Data may provide information about differences depending on the choice of anesthetic agent - Propofol versus Sevoflurane.