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Measurement of malondialdehyde as a marker of oxygen free radical production during renal allograft transplantation and the effect on early graft function.

We prospectively measured malondialdehyde (MDA), a marker of free radical oxygen damage during 44 renal transplant operations. When corrected for intra-operative changes in plasma volume, there was a significant increase in the ratio of MDA to total cholesterol (x10 3), from a median of 0.32 (0.24-0.44) (interquartile range) to 0.39 (0.31-0.50) at 30 minutes following reperfusion, p < 0.01 and to 0.36 (0.31-0.51) after 60 minutes, p < 0.01; whereas there was no intra-operative increase in MDA in 10 patients undergoing routine elective surgery, who acted as controls. The change in MDA/cholesterol ratio at both 30 and 60 minutes following reperfusion was greater in those patients with poor early graft function (serum creatinine > 250 umol/l at the end of the 1st post-operative week), mean 0.32 (sem 0.08) at 30 min and 0.32 (0.09) at 60 min, compared to those with good function (serum creatinine < 250 umol/l), 0.12 (0.05) and 0.10 (0.04) respectively, p < 0.05. This suggests that the products of oxygen free radical damage can be measured during renal transplantation, and that they may have an adverse effect on early graft function.