Use of fibrin sealant in vein anastomosis in renal transplantation and its effect in preventing blood loss and postoperative peri-graft collection.

Purpose: This study is to assess efficacy of fibrin sealant in vein anastomosis in renal transplantation in preventing blood loss and postoperative peri-graft collection.

Methods: This is a retrospective analytical case-control study of renal transplantations done in a tertiary care center in India in a 1-year period. Fibrin sealant was randomly used in vein anastomosis during the period. All the data were extracted and retrospectively analyzed. Those with fibrin sealant use were the study group and without sealant use were the control group. Primary objective was to assess effectiveness of fibrin sealant in preventing blood loss and postoperative peri-graft collection. Secondary objectives were to evaluate patients' demographic profile, hospital stay and other intraoperative and postoperative characteristics.

Results: During the study, 163 patients were enrolled, 82 study group and 81 control group. Warm ischemia, cold ischemia and operative times of study group were 2.57 ± 2.03, 44.23 ± 8.89 and 189.6 ± 51.6 min, respectively, and that of control group were 2.67 ± 2.07, 42.37 ± 8.5 and 178.8 ± 54.6 min, respectively. The mean intraoperative blood loss in study and control groups was 124.83 ± 110.89 and 155 ± 50.27 ml, respectively, and the difference was statistically significant (p .027). The mean peri-graft collection in study group and control group were 72.33 ± 29.18 ml and 134.67 ± 102.84 ml, respectively, but the difference was not statistically significant (p .086). The study also demonstrated that the duration of hospital stays significantly differed between two groups (p < .043).

Conclusion: In this study, fibrin sealant has demonstrated both safety and efficacy in effectively managing bleeding, sealing vascular anastomoses, and mitigating peri-graft collection.