Deceased donor recipients benefit from IV fluid therapy with balanced crystalloid solution
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ORLANDO — In deceased donor kidney transplant recipients, IV fluid therapy with balanced crystalloid solution reduced delayed graft function compared with saline solution, according to a presenter at ASN Kidney Week.
“These findings suggest balanced crystalloid solution should be the standard of care in IV fluids for deceased donor kidney transplantation,” Michael G. Collins, MBChB, FRACP, PhD, transplant nephrologist from Royal Adelaide Hospital in Australia, said at the late-breaking trial presentation.
According to Collins, the BEST-Fluids Trial was an investigator-initiated, pragmatic, registry-based, multicenter, double-blind, randomized controlled trial, in which researchers randomized 808 deceased donor kidney transplant recipients 1:1 to IV fluid therapy with balanced crystalloid solution or saline during surgery. The therapy continued up to 48 hours after the transplant until the fluids stopped.
Patients in the saline group underwent 596 dialysis treatments, whereas those in the balanced crystalloid group underwent 406 treatments.
Patients who received the balanced crystalloid solution showed a lower incidence of delayed graft function (30%) compared with those who received the saline (39.7%). Researchers did not identify differences in serum creatinine between the groups.
“To conclude, using a balanced crystalloid solution in deceased donor kidney transplantation reduced the incidence of delayed graft function compared to saline,” Collins said. “While the longer-term effects on graft failure and mortality remain uncertain, balanced crystalloids appear to be safe in transplantation.”
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Collins MG, et al. FR-OR61. Presented at: ASN Kidney Week; Nov. 3-6, 2022; Orlando (hybrid meeting).
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