Objective To investigate the effect of desflurane on the early postoperative acute kidney injury(AKI)after living donor liver transplantation in children.Methods A total of 113 children with biliary atresia undergoing living donor liver transplantation were divided into two groups.Group D(58 cases)received continuous inhalation of desflurane 1.0±0.3 MAC,and group P(55 cases)received continuous pumping of propofol medium/long chain fat milk 9-15 mg·kg-1·h-1 to maintain sedation.The relevant clinical and laboratory data were recorded.Serum levels of high mobility group protein B1(HMGB1),IL-6,TNF-α and cystatin C were detected after anesthesia induction(T1),one hour after reperfusion(T2),after surgery(T3),24 hours after surgery(T4)and 72 hours after surgery(T5).The occurrence and grade of AKI 3 days after surgery were evaluated,and postoperative recovery and prognosis were observed.Results Compared with group P,the incidences of intraoperative hypotension and using dopamine to maintain circulation were lower,serum levels of HMGB1,IL-6,TNF-α and cystatin C at T2-T4 were lower and that of cystatin C at T5 was lower,the incidence of grade 3 AKI and the overall incidence of AKI were decreased,and the mechanical ventilation time and ICU stay time were shorter in group D(P＜0.05).Conclusion Desflurane can alleviate the renal injury after reperfusion,reduce the incidence of early postoperative AKI and shorten the postoperative recovery time after living donor liver transplantation in children.The mechanism may be related to inhibiting the release of HMGB1 and the production of inflammatory factors after reperfusion,and alleviating the inflammatory injury of kidney.
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