Kidney failure is a significant health problem in New Zealand but results from an Auckland City Hospital (ACH)-led study will benefit many patients receiving a deceased donor kidney transplant.
The four-year BEST-Fluids trial found using an intravenous fluid, Plasma-Lyte 148, as a replacement for the usual saline used during surgery and the few days after, meant fewer patients require dialysis treatment following a transplant, reducing their recovery times, while also freeing up dialysis units for other patients waiting for treatment.
Nephrologist Dr Michael Collins, who led the research at ACH, alongside co-author and intensivist Dr Colin McArthur, says that in 2022 an estimated 5,500 Kiwis were receiving kidney replacement therapy; with over 2,000 patients living with a functioning kidney transplant and 3,000 on dialysis.
“While not everyone who is on dialysis is well enough to have a transplant, the team works very hard to get people on the transplant list where possible,” he says.
Dialysis requires patients to have their blood filtered for several hours, typically three times a week, says Dr McArthur. “It’s quite a major impact on their lifestyle and associated with a lot of complications. Whereas a kidney transplant provides a better lifestyle and longevity.”
And while it’s not uncommon for kidney transplant patients to need dialysis after surgery, until the new kidney is able to fully function on its own, the BEST-Fluids research indicates many patients will no longer require post-surgery dialysis at all, when Plasma-Lyte is used instead of saline, he says.
“Just a simple change of one fluid to another has meant for every ten patients receiving a transplant, one fewer will require dialysis in the days and week after surgery,” says Dr McArthur. “This means the time patients need to stay in ICU is reduced and fewer patients need dialysis, which benefits other patients who require those resources.”
Plasma-Lyte is now the usual intravenous fluid used at ACH for deceased donor kidney transplantation - and is currently under consideration at Christchurch and Wellington hospitals that also perform transplants. Drs Collins and McArthur say the trial results look to be good news for other kidney transplant patients around the world as well.
Visit Organ Donation New Zealand() to find accurate information on deceased organ and tissue donation in Aotearoa.
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Deceased organ donation |
The process of giving an organ or a part of an organ, at the time of the donor's death, for transplantation to another person. |
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Nephrologist |
A doctor who specialises in diagnosing and treating kidney conditions. |
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Dialysis |
Helps your body remove extra fluid and waste products from your blood when the kidneys are not able to. |
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