Abstract

Background: Metabolic disturbances during renal transplant can lead to electrophysiological and hemodynamic complications. Aims: To determine a relationship between electrophysiological parameters, metabolic homeostasis, length of cold ischemia time (CIT) and warm ischemia time (WIT).
Material/Methods: 54 renal transplant patients were included in a prospective study (mean age 45±12). Prior to procedure arterial blood gases' analysis was performed, digital holter ECG monitoring applied and continued for 12 hours. Second arterial blood gases' analysis was performed 30 minutes after graft's reperfusion. Electrophysiological parameters (rhythm disturbances, variation in the QT period, sinus rhythm variability) and metabolic parameters were analysed depending on the length of CIT and WIT.
Results: Mean CIT was 20 hours, WIT 22 minutes. Mean QTc period was initially 467ms, with its post-reperfusion lengthening to maximal values and gradual decrease during the first hour to initial values. Rapid QTc normalization was observed in WIT group (<17 minutes), dynamics of change were independent of CIT's length. Serious ventricular arrhythmia was observed in one patient. No significant changes were noticed when comparing metabolic compensation in the groups with CIT above and below 20 hours and groups with WIT below and above 22 minutes. Sinus rhythm variability was significantly disturbed in the group with WIT >16 minutes and was independent of the length of CIT.
Conclusions: 1. Prolongation of WIT results in repolarisation disturbances and presence of "fixed sinus rhythm". 2. Prolongation of CIT has no effect on lengthening of QTc or heart rate variability.

Keywords: Kidney Transplantation