Research Paper Volume 15, Issue 23 pp 14192—14209
The positive efficacy of dexmedetomidine on the clinical outcomes of patients undergoing renal transplantation: evidence from meta-analysis
- 1 Department of Nephropathy, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, PR China
- 2 Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
- 3 Center for Scientific Research of Anhui Medical University, Hefei, Anhui 230022, PR China
Received: June 15, 2023 Accepted: November 2, 2023 Published: December 11, 2023
https://doi.org/10.18632/aging.205296How to Cite
Copyright: © 2023 Guo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Introduction: Whether dexmedetomidine (DEX), an anesthetic adjuvant, can improve renal transplant outcomes is not clear.
Methods: We systematically identified clinical trials in which DEX was administered in renal transplantation (RT). On November 1, 2022, we searched The Cochrane Library, MEDLINE, EMBASE and https://www.clinicaltrials.gov/. The main outcomes were delayed graft function and acute rejection.
Results: A total of seven studies were included in the meta-analysis. The results showed that compared with the control, DEX significantly reduced the occurrence of delayed graft function (RR 0.76; 95% CI 0.60–0.98), short-term serum creatinine [postoperative day (POD) 2: (MD −22.82; 95% CI −42.01 – −3.64)] and blood urea nitrogen [POD 2: (MD −2.90; 95% CI −5.10 – −0.70); POD 3: (MD 2.07; 95% CI −4.12 – −0.02)] levels, postoperative morphine consumption (MD −4.27; 95% CI −5.92 – −2.61) and the length of hospital stay (MD −0.85; 95% CI−1.47 – −0.23). However, DEX did not reduce the risk of postoperative acute rejection (RR 0.75; 95% CI 0.45–1.23). The results of the subgroup analysis showed that country type, donor type, and average age had a certain impact on the role of DEX.
Conclusions: DEX may improve the short-term clinical outcome of RT and shorten the length of hospital stay of patients.
Abbreviations
AKI: acute kidney injury; BUN: blood urea nitrogen; DEX: dexmedetomidine; DGF: delayed graft function; ESRD: end-stage renal disease; IRI: ischemia–reperfusion injury; LOS: length of hospital stay; POD: postoperative day; RT: renal transplantation.