Efficacy and safety of sugammadex in patients undergoing renal transplantation

BACKGROUND: Sugammadex reverses rocuronium by encapsulating it, creating a stable complex that is mainly excreted by the kidneys. Nonetheless, in view of exposure to sugammadex during renal transplantation, current safety data are insufficient. We retrospectively investigated the safety and efficacy of sugammadex in the immediate perioperative period and over long-term follow-up. CASE PRESENTATION: We studied 99 consecutive patients who underwent living renal transplantation. We investigated the efficacy of sugammadex and its perioperative complications in the first 48–72 h in the surgical intensive care unit and in the follow-up for 6 months. Before transplantation, 53 patients required hemodialysis. The median serum creatinine concentration was 5.6 mg/dl, and blood urea nitrogen (BUN) was 30 mg/dl. During surgery, the median rocuronium and sugammadex dose was 160 mg (interquartile range 130–185 mg) and 200 mg (200–200 mg), respectively. After transplantation, the median serum creatinine concentration was 2.4 mg/dl at postoperative day 1, and BUN was 21 mg/dl, respectively. No adverse events were recorded during the observation period. CONCLUSION: We investigated whether 99 consecutive patients undergoing renal transplantation may benefit from the use of sugammadex. There were no adverse events. We concluded that, in our observational period, sugammadex was efficacious and safe in patients who underwent renal transplantation.