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DC Field | Value | Language |
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dc.contributor.author | Collins, M. G. | - |
dc.contributor.author | Fahim, M. A. | - |
dc.contributor.author | Pascoe, E. M. | - |
dc.contributor.author | Hawley, C. M. | - |
dc.contributor.author | Johnson, D. W. | - |
dc.contributor.author | Varghese, J. | - |
dc.contributor.author | Hickey, L. E. | - |
dc.contributor.author | Clayton, P. A. | - |
dc.contributor.author | Dansie, K. B. | - |
dc.contributor.author | McConnochie, R. C. | - |
dc.contributor.author | Vergara, L. A. | - |
dc.contributor.author | Kiriwandeniya, C. | - |
dc.contributor.author | Reidlinger, D. | - |
dc.contributor.author | Mount, P. F. | - |
dc.contributor.author | Weinberg, L. | - |
dc.contributor.author | McArthur, C. J. | - |
dc.contributor.author | Coates, P. T. | - |
dc.contributor.author | Endre, Z. H. | - |
dc.contributor.author | Goodman, D. | - |
dc.contributor.author | Howard, K. | - |
dc.contributor.author | Howell, M. | - |
dc.contributor.author | Jamboti, J. S. | - |
dc.contributor.author | Kanellis, J. | - |
dc.contributor.author | Laurence, J. M. | - |
dc.contributor.author | Lim, W. H. | - |
dc.contributor.author | McTaggart, S. J. | - |
dc.contributor.author | O'Connell, Philip J. | - |
dc.contributor.author | Pilmore, H. L. | - |
dc.contributor.author | Wong, Germaine | - |
dc.contributor.author | Chadban, S. J. | - |
dc.contributor.author | Ying, T. | - |
dc.contributor.author | Gracey, D. | - |
dc.contributor.author | Aouad, L. | - |
dc.contributor.author | Wyburn, K. | - |
dc.contributor.author | Habijanec, B. | - |
dc.contributor.author | Yeo, H. E. E. | - |
dc.contributor.author | Lin, L. | - |
dc.contributor.author | Rosales, B. | - |
dc.contributor.author | Hudaly, J. | - |
dc.contributor.author | Rodrigues, V. | - |
dc.contributor.author | O'Connell, P. | - |
dc.contributor.author | Murie, P. | - |
dc.contributor.author | Endre, Z. | - |
dc.contributor.author | Gray, Z. | - |
dc.contributor.author | Spicer, R. | - |
dc.contributor.author | Durkan, A. | - |
dc.contributor.author | Jegatheesan, D. | - |
dc.contributor.author | Leary, D. | - |
dc.contributor.author | Guo, Y. S. | - |
dc.contributor.author | Coburn, A. | - |
dc.contributor.author | Irvine, R. | - |
dc.contributor.author | McTaggart, S. | - |
dc.contributor.author | Crawford, A. | - |
dc.contributor.author | Hockley, B. | - |
dc.contributor.author | Fischer, K. | - |
dc.contributor.author | Mount, P. | - |
dc.contributor.author | Baulch, S. | - |
dc.contributor.author | Claxton, G. | - |
dc.contributor.author | Harris, S. | - |
dc.contributor.author | Sidiropoulos, S. | - |
dc.contributor.author | Veenendal, M. | - |
dc.contributor.author | Barbis, R. | - |
dc.contributor.author | Brahmbhatt, A. | - |
dc.contributor.author | Le Page, A. | - |
dc.contributor.author | Jamboti, J. | - |
dc.contributor.author | Chiam, A. | - |
dc.contributor.author | Warger, A. | - |
dc.contributor.author | Collins, M. | - |
dc.contributor.author | Pilmore, H. | - |
dc.contributor.author | Dittmer, I. | - |
dc.contributor.author | Manley, P. | - |
dc.contributor.author | Ahmed, J. | - |
dc.contributor.author | McConnochie, R. | - |
dc.contributor.author | Newby, L. | - |
dc.contributor.author | Chen, Y. | - |
dc.contributor.author | Simmonds, C. | - |
dc.contributor.author | Irvine, J. | - |
dc.contributor.author | Usher, J. | - |
dc.contributor.author | Clark, C. | - |
dc.contributor.author | Beckett, C. | - |
dc.contributor.author | Prestidge, C. | - |
dc.contributor.author | Erickson, R. | - |
dc.contributor.author | Rea, M. | - |
dc.contributor.author | Scherring, C. | - |
dc.contributor.author | B. EST-Fluids Investigators | - |
dc.contributor.author | Australasian Kidney Trials, Network | - |
dc.date.accessioned | 2024-01-23T01:00:07Z | - |
dc.date.available | 2024-01-23T01:00:07Z | - |
dc.date.issued | 2023 | - |
dc.identifier.citation | The Lancet 402(10396):105-117, 2023 | - |
dc.identifier.uri | https://wslhd.intersearch.com.au/wslhdjspui/handle/1/8339 | - |
dc.description.abstract | Background: Delayed graft function (DGF) is a major adverse complication of deceased donor kidney transplantation. Intravenous fluids are routinely given to patients receiving a transplant to maintain intravascular volume and optimise graft function. Saline (0·9% sodium chloride) is widely used but might increase the risk of DGF due to its high chloride content. We aimed to test our hypothesis that using a balanced low-chloride crystalloid solution (Plasma-Lyte 148) instead of saline would reduce the incidence of DGF. Methods: BEST-Fluids was a pragmatic, registry-embedded, multicentre, double-blind, randomised, controlled trial at 16 hospitals in Australia and New Zealand. Adults and children of any age receiving a deceased donor kidney transplant were eligible; those receiving a multi-organ transplant or weighing less than 20 kg were excluded. Participants were randomly assigned (1:1) using an adaptive minimisation algorithm to intravenous balanced crystalloid solution (Plasma-Lyte 148) or saline during surgery and up until 48 h after transplantation. Trial fluids were supplied in identical bags and clinicians determined the fluid volume, rate, and time of discontinuation. The primary outcome was DGF, defined as receiving dialysis within 7 days after transplantation. All participants who consented and received a transplant were included in the intention-to-treat analysis of the primary outcome. Safety was analysed in all randomly assigned eligible participants who commenced surgery and received trial fluids, whether or not they received a transplant. This study is registered with Australian New Zealand Clinical Trials Registry, (ACTRN12617000358347), and ClinicalTrials.gov (NCT03829488). Findings: Between Jan 26, 2018, and Aug 10, 2020, 808 participants were randomly assigned to balanced crystalloid (n=404) or saline (n=404) and received a transplant (512 [63%] were male and 296 [37%] were female). One participant in the saline group withdrew before 7 days and was excluded, leaving 404 participants in the balanced crystalloid group and 403 in the saline group that were included in the primary analysis. DGF occurred in 121 (30%) of 404 participants in the balanced crystalloid group versus 160 (40%) of 403 in the saline group (adjusted relative risk 0·74 [95% CI 0·66 to 0·84; p<0·0001]; adjusted risk difference 10·1% [95% CI 3·5 to 16·6]). In the safety analysis, numbers of investigator-reported serious adverse events were similar in both groups, being reported in three (<1%) of 406 participants in the balanced crystalloid group versus five (1%) of 409 participants in the saline group (adjusted risk difference -0·5%, 95% CI -1·8 to 0·9; p=0·48). Interpretation: Among patients receiving a deceased donor kidney transplant, intravenous fluid therapy with balanced crystalloid solution reduced the incidence of DGF compared with saline. Balanced crystalloid solution should be the standard-of-care intravenous fluid used in deceased donor kidney transplantation. | - |
dc.subject | Nephrology | - |
dc.title | Balanced crystalloid solution versus saline in deceased donor kidney transplantation (BEST-Fluids): a pragmatic, double-blind, randomised, controlled trial | - |
dc.type | Journal Article | - |
dc.identifier.doi | https://doi.org/10.1016/S0140-6736(23)00642-6 | - |
dc.subject.keywords | Crystalloid solutions | - |
dc.subject.keywords | Kidney transplantation | - |
dc.subject.keywords | Chlorides | - |
dc.identifier.journaltitle | The Lancet | - |
dc.identifier.department | Nephrology | - |
dc.contributor.wslhd | O'Connell, Philip J. | - |
dc.contributor.wslhd | Wong, Germaine | - |
dc.type.studyortrial | Multicenter Study | - |
dc.type.studyortrial | Randomized Controlled Trial | - |
dc.identifier.pmid | 37343576 | - |
dc.identifier.affiliation | Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA, Australia | - |
dc.identifier.affiliation | Department of Renal Medicine, Auckland City Hospital, Auckland, New Zealand | - |
dc.identifier.affiliation | Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand | - |
dc.identifier.affiliation | Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia | - |
dc.identifier.affiliation | Australasian Kidney Trials Network, Centre for Health Services Research, University of Queensland, Brisbane, QLD, Australia | - |
dc.identifier.affiliation | Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, QLD, Australia | - |
dc.identifier.affiliation | Translational Research Institute, Brisbane, QLD, Australia | - |
dc.identifier.affiliation | Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia | - |
dc.identifier.affiliation | Department of Nephrology, Austin Health, Melbourne, VIC, Australia | - |
dc.identifier.affiliation | Department of Anaesthesia, Austin Health, Melbourne, VIC, Australia | - |
dc.identifier.affiliation | Department of Medicine (Austin), University of Melbourne, Melbourne, VIC, Australia | - |
dc.identifier.affiliation | Department of Critical Care, University of Melbourne, Melbourne, VIC, Australia | - |
dc.identifier.affiliation | Department of Nephrology, Prince of Wales Hospital, Sydney, NSW, Australia | - |
dc.identifier.affiliation | Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia | - |
dc.identifier.affiliation | Department of Nephrology, St Vincent's Hospital, Melbourne, VIC, Australia | - |
dc.identifier.affiliation | School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia | - |
dc.identifier.affiliation | Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, NSW, Australia | - |
dc.identifier.affiliation | Institute of Academic Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia | - |
dc.identifier.affiliation | Centre for Transplant and Renal Research, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia | - |
dc.identifier.affiliation | Kidney Node, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia | - |
dc.identifier.affiliation | Department of Nephrology and Renal Transplantation, Fiona Stanley Hospital, Murdoch, WA, Australia | - |
dc.identifier.affiliation | School of Medicine, University of Western Australia, Perth, WA, Australia | - |
dc.identifier.affiliation | Department of Nephrology, Monash Health, Melbourne, VIC, Australia | - |
dc.identifier.affiliation | Centre for Inflammatory Diseases, Department of Medicine, Monash University, Melbourne, VIC, Australia | - |
dc.identifier.affiliation | Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia | - |
dc.identifier.affiliation | Child and Adolescent Renal Service, Queensland Children's Hospital, Brisbane, QLD, Australia | - |
dc.identifier.affiliation | Department of Renal and Transplantation Medicine, Westmead Hospital, Sydney, NSW, Australia | - |
dc.identifier.affiliation | Department of Medicine, University of Auckland, Auckland, New Zealand | - |
dc.identifier.affiliation | Department of Renal Medicine, Kidney Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia | - |
dc.identifier.facility | Blacktown | - |
dc.identifier.facility | Westmead | - |
dc.identifier.facility | Auburn | - |
Appears in Collections: | Westmead Hospital 2019 - 2024 |
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