The effect of goal-directed fluid therapy on delayed graft function in kidney transplant recipients : A systematic review and meta-analysis
Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved..
Delayed graft function (DGF) is a common post-operative complication with potential long-term sequelae for many kidney transplant recipients, and hemodynamic factors and fluid status play a role. Fixed perioperative fluid infusions are the standard of care, but more recent evidence in the non-transplant population has suggested benefit with goal-directed fluid strategies based on hemodynamic targets. We searched MEDLINE, EMBASE, Cochrane Controlled Trials Registry and Google Scholar through December 2022 for randomized controlled trials comparing risk of DGF between goal-directed and conventional fluid therapy in adults receiving a living or deceased donor kidney transplant. Effect estimates were reported with odds ratios (OR) and pooled using random effects meta-analysis. We identified 4 studies (205 participants) that met the inclusion criteria. The use of goal-directed fluid therapy had no significant effect on DGF (OR 1.37 95% CI, 0.34-5.6; p = 0.52; I2 = 0.11). Subgroup analysis examining effects among deceased and living kidney donation did not reveal significant differences in the effects of fluid strategy on DGF between subgroups. Overall, the strength of the evidence for goal-directed versus conventional fluid therapy to reduce DGF was of low certainty. Our findings highlight the need for larger trials to determine the effect of goal-directed fluid therapy on this patient-centered outcome.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
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| Enthalten in: |
Transplantation reviews (Orlando, Fla.) - 38(2024), 2 vom: 01. Apr., Seite 100834 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Klonarakis, Michael P [VerfasserIn] |
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| Links: |
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| Themen: |
Delayed graft function |
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| Anmerkungen: |
Date Completed 05.04.2024 Date Revised 05.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.trre.2024.100834 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368253864 |
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| 100 | 1 | |a Klonarakis, Michael P |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The effect of goal-directed fluid therapy on delayed graft function in kidney transplant recipients |b A systematic review and meta-analysis |
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| 520 | |a Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a Delayed graft function (DGF) is a common post-operative complication with potential long-term sequelae for many kidney transplant recipients, and hemodynamic factors and fluid status play a role. Fixed perioperative fluid infusions are the standard of care, but more recent evidence in the non-transplant population has suggested benefit with goal-directed fluid strategies based on hemodynamic targets. We searched MEDLINE, EMBASE, Cochrane Controlled Trials Registry and Google Scholar through December 2022 for randomized controlled trials comparing risk of DGF between goal-directed and conventional fluid therapy in adults receiving a living or deceased donor kidney transplant. Effect estimates were reported with odds ratios (OR) and pooled using random effects meta-analysis. We identified 4 studies (205 participants) that met the inclusion criteria. The use of goal-directed fluid therapy had no significant effect on DGF (OR 1.37 95% CI, 0.34-5.6; p = 0.52; I2 = 0.11). Subgroup analysis examining effects among deceased and living kidney donation did not reveal significant differences in the effects of fluid strategy on DGF between subgroups. Overall, the strength of the evidence for goal-directed versus conventional fluid therapy to reduce DGF was of low certainty. Our findings highlight the need for larger trials to determine the effect of goal-directed fluid therapy on this patient-centered outcome | ||
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Delayed graft function | |
| 650 | 4 | |a Fluid strategies | |
| 650 | 4 | |a Kidney transplantation | |
| 650 | 4 | |a meta-analysis | |
| 700 | 1 | |a Dhillon, Mannat |e verfasserin |4 aut | |
| 700 | 1 | |a Sevinc, Emir |e verfasserin |4 aut | |
| 700 | 1 | |a Elliott, Meghan J |e verfasserin |4 aut | |
| 700 | 1 | |a James, Matthew T |e verfasserin |4 aut | |
| 700 | 1 | |a Lam, Ngan N |e verfasserin |4 aut | |
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| 700 | 1 | |a Ruzycki, Shannon M |e verfasserin |4 aut | |
| 700 | 1 | |a Harrison, Tyrone G |e verfasserin |4 aut | |
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