Effects Of Sevoflurane Preconditioning On Renal Function Of Controllable Donation After Cardiac Death (DCD)

Objective: The aim was to investigate the effects of sevoflurane pretreatment on renal function in patients undergoing DCD donor renal transplantation,with comparing the changes of renal function after renal transplantation.Methods: From September 2016 to December 2017,we selected 102 donors and 179 recipients who underwent DCD renal transplantation in urology department of our hospital.All cases conformed to medical ethics and signed consent for organ donation,operation and clinical trials.102 donors were randomly divided into sevoflurane pretreatment group（S group）and control group（C group）,50 donors and 52 donors,respectively.The donor was given 2% sevoflurane + 100% pure oxygen inhalation in group S and 100% pure oxygen inhalation in group C until cardiopulmonary function support was withdrawn.After irreversible stopping of circulation,liver and kidneys were removed.Observation Indicators: serum creatinine,urea nitrogen,glomerular filtration rate which was calculated by the formula e GFR（ml/min）=186x（Scr,mg/dl）^-1.154x（age）^-0.203x（0.742females）,24-hour urine volume,total duration of hospitalization and related complications（PNF,DGF,AR）.Results: 1.General information of donors: there was no significant difference in sex,age,cause of death,serum creatinine,urea nitrogen values,cold and warm ischemia time,norepinephrine,dopamine and total liquid volume between the two groups（P > 0.05）.2.General information of receptors: gender,age,concomitant diseases,dialysis time and dialysis mode,serum creatinine,urea nitrogen levels and glomerular filtration rate were not significantly different between the two groups（P > 0.05）.3.Postoperative indicators: serum creatinine values in group S and group C decreased significantly within 1 week after operation.Compared with group S,serum creatinine levels in group C were higher 7 days after operation,with significant difference between the two groups（P<0.05）;24-hour urine volume in group S was higher than that in group C,with significant difference between the two groups（P<0.05）;glomerular filtration rate in group S was slightly higher than that in group C,but with no significant difference between the two groups（P > 0.05）.And there was no significant difference in hospitalization time and related complications between the two groups（P > 0.05）.conclusion: Sevoflurane pretreatment has a protective trend on renal function of controllable cardiac death organ donation（DCD）donors.