Effects of sevoflurame combined anesthsia on kidney function in pediatric living donor liver transplantation

Hongxia Li, Y. Weng, Wenli Yu
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Abstract

Objective To evaluate the effect of propofol and sevoflurane on acute kidney function in infants undergoing pediatric parent liver transplantation. Methods 80 pediatric patients scheduled for pediatric liver transplantation were randomly assigned to receive either continuous infusion of propofol or inhalation of sevoflurane. Serum creatinine (Scr), inflammatory medium and renal biomarkers were measured before surgery (T1), 30min after anhepatic phase (T2), 3h after ischemia reperfusion (T3), 36 h after surgery(T4) to evaluate the effect of anesthetics on the development of postoperative kidney injury. Results Overall, compared Propofol group, the mean arterial pressure changed slightly in sevoflurane group. The inflammatory factors of Scr, IL-18, TNF-α, and levels of NGAL were lower in sevoflurane group while no differences of IL-10 were found between both groups. Conclusions Compared with propofol anesthesia, the degree of renal injury in pediatric living donor liver transplantion under sevoflurane anesthesia is reduced, which may be related to hemodynamic stability and decreased release of inflammatory factors. Key words: Pediatric liver transplantation; Sevoflurane; Acute kidney injury
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七氟乐联合麻醉对儿童活体肝移植肾功能的影响
目的探讨异丙酚和七氟醚对小儿父母肝移植术后患儿急性肾功能的影响。方法80例小儿肝移植患者随机分为连续输注异丙酚组和吸入七氟醚组。分别于术前(T1)、无肝期后30min (T2)、缺血再灌注后3h (T3)、术后36 h (T4)测定血清肌酐(Scr)、炎症介质及肾脏生物标志物,评价麻醉药物对术后肾损伤发展的影响。结果与异丙酚组比较,七氟醚组平均动脉压变化不大。七氟醚组炎症因子Scr、IL-18、TNF-α及NGAL水平均降低,IL-10水平无显著差异。结论与异丙酚麻醉相比,七氟醚麻醉下儿童活体肝移植肾损伤程度减轻,这可能与血流动力学稳定、炎症因子释放减少有关。关键词:小儿肝移植;七氟醚;急性肾损伤
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