Anaesthesia for renal transplantation: an update

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“…Appropriate anesthesia technique should be selected taking into account the existing diseases of the patient, the duration of surgery and the possibilities of renal protection [5]. Regardless of the method of anesthesia, varicose stockings and blankets in which active heating can be provided should be used to prevent the destructive effect of hypothermia on the graft in terms of mechanical thrombophylaxis [3]. The use of central regional methods is rare and controversial in patients with chronic renal failure DOI: 10.46718/JBGSR.2020.03.000079 [6][7][8].…”

“…Instead, non-invasive blood pressure monitoring is sufficient. Care should be taken to use the leg in the contralateral side of the side to which the allograft will be attached if the cuff is placed on the arm without AV fistula, if it cannot be used in both arms for some reason and the measurement will be made from the lower extremity [3]. Transesophageal echocardiography can be used in patients with ventricular insufficiency, pulmonary hypertension, or advanced coronary artery disease.…”

Abdominal Organ Transplantation: Noteworthy Literature in 2018

“…Although the utility of central venous pressure (CVP) monitoring for fluid management has been called into question, [18][19][20] some still advocate for CVP monitoring during kidney transplantation to guide fluid responsiveness or to provide postoperative dialysis access for patients without arteriovenous grafts. [15][16][17] Generally, arterial catheters (ACs) are advocated for patients with multiple comorbidities, particularly cardiac. 15,17,21 In 2018, a large, retrospective study using data from the National Anesthesia Clinical Outcomes Registry (NACOR) was conducted to determine variations in invasive monitoring techniques during kidney transplantation in the United States.…”

“…[15][16][17] Generally, arterial catheters (ACs) are advocated for patients with multiple comorbidities, particularly cardiac. 15,17,21 In 2018, a large, retrospective study using data from the National Anesthesia Clinical Outcomes Registry (NACOR) was conducted to determine variations in invasive monitoring techniques during kidney transplantation in the United States. The authors included 10 580 kidney transplant anesthetics from 100 hospitals in the analysis.…”

“…Optimized fluid therapy may improve outcomes in kidney transplant recipients; however, implementation of appropriate fluid therapy and hemodynamic monitoring remains highly varied among institutions during kidney transplantation. 14-17 The therapeutic window for fluid administration is likely small, with hypovolemia leading to acute kidney injury (AKI) and possibly delayed graft function (DGF), whereas hypervolemia can lead to CV complications, including pulmonary edema. 14 Central venous catheter (CVC) placement remains debated.…”