Effect of Isoflurane versus Propofol on the Early Outcome of Living Donor Adult Kidney Transplantation

Background: Optimizing anesthetic management for the best possible outcome is essential in kidney transplantation (KT). Objective: To evaluate the difference in grafted kidney function and early kidney transplant outcome when the pairs of donor-recipient were anesthetized with isoflurane compared to propofol. Methods: Thirty-eight pairs of kidney transplant donor-recipient were anesthetized with isoflurane, and 22 pairs were anesthetized with propofol. Blood urea nitrogen (BUN), serum creatinine (SCr), estimated glomerular filtration rate (eGFR) were assessed in the preoperative period, on the first postoperative day, before discharge from the hospital, and 6 months after KT. Short-term (6 months) outcomes of KT were assessed by the incidence of delayed graft function, acute rejection episodes, and graft failure. Results: There was no statistically significant difference between the two groups in the serial measurements of SCr, BUN, eGFR, and the early outcomes (6 months) after surgery. Interestingly, donor warm ischemic time in the propofol group was significantly longer than in the isoflurane group (4.05±1.02, 2.93±0.87 minutes, respectively) (p=0.001). Moreover, postoperative hospital stay in the propofol group were significantly shorter compared to the isoflurane group (9.63±2.96, 11.78±4.91 days, respectively) (p=0.02). Conclusion: There were no significant differences in transplanted kidney function and the early outcome of kidney transplantation between the two study groups. However, earlier hospital discharge after surgery in the propofol group suggests that propofol may be a more appropriate anesthetic choice in these patients.