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Volume: 6 Issue: 4 November 2008 - Supplement - 1



End stage renal disease has many causes and the best treatment for this condition is kidney transplantation. DGF is one of the numerous complications of kidney transplantation. Many pathogenic factors have been considered and the effect of ischemia and reperfusion is one of them. In this study we assessed the ability of hypoxanthine and xanthine concentration in transplanted kidney venous blood measurement to predict DGF. From March 2004 to September 2005, we carried out renal vein blood sampling during and immediately after transplantation in 47 patients. After measurement of purine metabolites with HPLC in blood samples, the metabolite rise or not with respect to baseline level was evaluated. All patients were followed for the next 4 days. Each patient was then assigned in one of the metabolite increased or not increased group and then the relationship between purine metabolite rise with DGF and other related factors (recipient and donor age, operation time, anastomosing time, vascular reclamping) was assessed with fisher’s exact test. 30 male (% 63) and 17 female (%37) patients with mean age 34.8 year were studied. In 17 patients the purine metabolite raised and in other 30 patients no change were noticed. These changes were significant only for hypoxanthine (Mean increase 1.28 mg/l ± 1.57 mg/l in the raised group in comparison with -0.32 mg/l ± 4 in no change group, P < 0.001). In the raised group 5 persons (%29.4) and in not raised group 3 persons (%10) developed DGF but in analytical assessment no relationship was found between two variable (P = 0.118). Among the other effective factors in development of DGF, only the anastomosing time had significant relationship with increase in metabolite level. (mean time 40 min ± 7.81 in reseal group in comparison with 35 min ± 7.37 in the other group (P= 0.035). In conclusion, although cold ischemia for short period during kidney transplantation can increase serum hypoxanthine level; it is not a marker of sever ischemia. In this study we could not give a precise conclusion about the significance of changes in serum xanthine level after reperfusion during ischemia of short duration because this condition was not observed in our study. It seems that for predicting DGF considering factors like reclamping of renal vessels during transplantation and urine flow after vascular anastomosis are better indicators.

Volume : 6
Issue : 4
Pages : 93

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Ahwaz Transplant Center, Golestan Hospital, Joundishapour University of Medical Sciences, Ahwaz, Iran,