Fluid management in living donor hepatectomy: Recent issues and perspectives

Table 1 Controversial effects of intraoperative colloid administration on the outcomes of surgical patients

Ref.	Study design	Types of surgery (n)	Types of colloid	Clinical outcomes of colloid
Mukhtar et al[77]	RCT	Living donor liver transplantation (40)	6% HES 130/0.4 vs Alb	No difference in renal outcome
Rioux et al[78]	Retrospective, propensity score matching	Cardiac surgery (254)	10% pentastarch 250/0.45 (< 14 mL/kg vs≥ 14 mL/kg)	Dose-dependent renal toxicity
Hokema et al[79]	Retrospective	Renal transplantation (113)	6% HES 130/0.4 vs NS or RA	No difference in delayed renal graft function
Martin et al[64]	Meta-analysis	Various surgical procedures (1230)	6% HES 130/0.4 vs comparators1	No differences in renal outcome and length of hospital stay
Canet et al[80]	Prospective observational, propensity score matching, multicenter	General surgery (2462)	Colloids2vs crystalloids	Increased pulmonary or cardiovascular complications and length of hospital stay
				No difference in mortality
Van der Linden et al[81]	RCT, double-blind, two-center	Pediatric cardiac surgery (61)	6% HES 130/0.4 vs Alb	No differences in complications
Skhirtladze et al[82]	RCT, double-blind	Cardiac surgery (236)	6% HES 130/0.4 vs Alb vs RL	Both colloids increased blood transfusion, decreased coagulation and increased the creatinine level
Rasmussen et al[83]	RCT	Cystectomy (33)	6% HES 130/0.4 vs RL	Increased blood loss and decreased coagulation
				No differences in re-operation and hospital stay
Kancir et al[84]	RCT	Hip arthroplasty (38)	6% HES 130/0.4 vs NS	No harmful effect on renal function
Lindroos et al[85]	RCT	Neurosurgery (30)	6% HES 130/0.4 vs RA	Decreased coagulation
				No differences in blood loss
Yates et al[86]	RCT, double-blind	Colorectal surgery (202)	6% HES 130/0.4 vs RL	No differences in complications
Gillies et al[65]	Meta-analysis	Non-cardiac surgery (1567)	6% HES vs comparators1	No differences in mortality or AKI
Kashy et al[87]	Retrospective, propensity score matching	Non-cardiac and non-urological surgery (29360)	Colloids3vs crystalloids	Dose-dependent renal toxicity
Mercier et al[88]	RCT, double-blind, multicenter	Caesarean section (167)	6% HES 130/0.4 vs RL	Same effects in both mother and neonate
Hand et al[89]	Retrospective, propensity score matching	Deceased donor liver transplantation (174)	6% HES 130/0.4 vs Alb	6% HES increase risk of AKI
Kancir et al[90]	RCT, double-blind	Radical prostatectomy (36)	6% HES 130/0.4 vs NS	No difference in renal outcome
Choi et al[91]	Retrospective	Living donor hepatectomy (1969 )	6% HES 130/0.4 vs crystalloids	Postoperative delayed recovery of hepatic function

¹Comparators included crystalloid solutions, gelatin solutions, and albumin;

²Mainly 6% HES 130/0.4;

³Mainly 6% hexastarch 670/0.75. AKI: Acute kidney injury; Alb: 5% human albumin; HES: Hydroxyethyl starch; NS: Normal saline; RA: Ringer’s acetate solution; RCT: Randomized controlled trial; RL: Ringer’s lactate solution.