Perioperative Hydration Policy

The number of Kidney transplants has increased in last decades for many advances in diagnostic and therapeutic reasons. Kidney transplantation results in superior life expectancy and better quality of life if compared to dialysis treatment for patients with endstage renal failure. The success of graft survival after kidney transplantation is closely associated with early graft function based on intraoperative perfusion characteristics of the allograft and good urine output. Clinicians must carefully adjust intravascular volume and arterial blood pressure to effectively perfuse the graft, and the time course of volume expansion seems important for adequate hydration. The ultimate goal for any renal transplantation patient is to have an optimally functioning graft as early as possible after completion of surgery. Key strategies that are used to achieve this goal involve the optimal management of the intravascular volume and achievement of early urine output. One of the reasons for graft failure after renal transplantation is inadequate graft perfusion caused by mis-management of perioperative hydration policy.