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Int J Med Sci 2012; 9(5):391-396. doi:10.7150/ijms.4468

Research Paper

Post-reperfusion Syndrome during Renal Transplantation: A Retrospective Study

Steven R. Bruhl1, Sandeep Vetteth2, Michael Rees3, Blair P. Grubb1, Samer J. Khouri1✉

1. Division of Cardiology, 3000 Arlington Ave., Toledo, OH 43537, USA
2. Division of Nephrology, 3000 Arlington Ave., Toledo, OH 43537, USA
3. Department of Urology, 3000 Arlington Ave., Toledo, OH 43537, USA


Post-reperfusion syndrome (PRS) is a serious, widely reported complication following the reperfusion of an ischemic tissue or organ. We sought to determine the prevalence, risk factors and short-term outcomes of PRS related renal transplantation. We conducted a retrospective, case-control study of patients undergoing renal transplantation between July 2006 and March 2008. Identification of PRS was based on a drop in mean arterial pressure by at least 15% within 5 minutes of donor kidney reperfusion. Of the 150 consecutive renal transplantations reviewed, 6 patients (4%) met criteria for post-reperfusion syndrome. Univariate analysis showed that an age over 60, diabetes mellitus, Asian race, and extended criteria donors increased the odds of developing PRS by 4.8 times (95% CI [1.2, 20]; P=.0338), 4.5 times (95% CI [1.11, 18.8]; P=.0378), 35.5 times (95% CI [3.94, 319.8]; P=0.0078) and 9.6 times (95% CI [1.19, 76.28] P=0.0115) respectively. Short term follow-up revealed increased graft failure rate within 6 months (6% vs. 16% P=0.0125) and almost twice the number of hospital days post-transplant in PRS cohorts (5.43 ± 2.29 vs. 10.8 ± 7.29 P=<0.0001). Despite limited reporting, PRS appears to be a relatively common complication of renal transplantation and is associated with increase morbidity.

Keywords: Post reperfusion syndrome, PRS, renal transplant, transplant complications, hypotension.

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How to cite this article:
Bruhl SR, Vetteth S, Rees M, Grubb BP, Khouri SJ. Post-reperfusion Syndrome during Renal Transplantation: A Retrospective Study. Int J Med Sci 2012; 9(5):391-396. doi:10.7150/ijms.4468. Available from