Anesthesia for Kidney and Pancreas Transplantation

Mittel, Aaron; Wagener, Gebhard

doi:10.1016/j.anclin.2017.04.005

Cited by 24 publications

(29 citation statements)

References 53 publications

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“…In 2017, 2646 (79.3%) of the 3330 RTs were performed from living donors and 684 (20.7%) were from deceased donors [1]. In developed countries, 70-80% of kidney transplantations are reported from a deceased and 20-30% from living donor [6]. In our study, we found that the cadaveric transplantation rate (78.6%) was similar to that in developed countries.…”

Section: Discussionsupporting

confidence: 73%

“…Previous publications have reported that performing dialysis 24 hours prior to transplantation cause delay in graft functions. However, in recent years it has been emphasized that treatment should be managed on a case basis manner [6,13]. All of our patients underwent dialysis in the pre-transplantation period.…”

Section: Discussionmentioning

confidence: 98%

“…It is known that preemptive transplantation improves graft function and decreases mortality compared to transplantation in patients undergoing dialysis. However, it has also been reported that if the patient requires dialysis, initiation of dialysis together with scheduled transplantation within six months does not affect organ survival [6][7]. For this reason, the current guidelines recommend that patients should be enrolled in the transplantation list within six months from the estimated date of dialysis initiation [6,8].…”

Section: Discussionmentioning

confidence: 99%

“…However, it has also been reported that if the patient requires dialysis, initiation of dialysis together with scheduled transplantation within six months does not affect organ survival [6][7]. For this reason, the current guidelines recommend that patients should be enrolled in the transplantation list within six months from the estimated date of dialysis initiation [6,8]. On the other hand, it is observed that the number of transplantation in our country has increased in recent years and this increase is mainly due to the increase in preemptive transplantations (38.4%) [1].…”

Section: Discussionmentioning

confidence: 99%

“…In the evaluation of intravascular volume during transplantation, central venous pressure (CVP) was recommended to be maintained between 10-15 mmHg [5][6]14]. In recent years, it has been reported that this is not completely valid and hypovolemia can also be determined by intra-arterial dynamic measurements (pulse pressure, stroke volume variability, etc.).…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Anesthesiology experience with patients underwent renal transplantation at a university hospital: first-year results

Yılmaz¹

2020

Ann Clin Anal Med

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Aim: Renal transplantation (RT) is the most effective treatment modality for end-stage renal disease (ESRD). Transplantation process requires a multidisciplinary (nephrologist, surgeon, anesthetist, pathologist, immunologist, and experienced nurse) approach. This study presents the first-year experience of the anesthesiology department of a university hospital where renal transplantation program just started. Material and Method: The digital medical files of 14 patients who underwent renal transplantation due to ESRD between 2017 and 2018 were evaluated retrospectively. The hemodynamic and demographic parameters of all the patients were examined and analyzed. Results: Eleven (78.6%) of the donors were provided from deceased and 3 (21.4%) from living individuals. The mean age of all transplantation patients were 39.9±13.3 years (range 21-61). Concerning cause, "unknown etiology" was detected in 8 (57.1%) of the patients. None of the patients experienced difficult intubation. The mean duration of anesthesia was 242.8 ± 85.2 min. Intraoperative hypotension was detected in 6 (42.8%) patients. During the intraoperative period, 1535 ± 771 ml of 0.9% NaCl was administered as the fluid maintenance. Only 2 patients had intraoperative complications. No mortality was observed during the perioperative period. Two of the 14 patients experienced loss of the transplanted kidney. The survival rate of the grafts was 85.8%. Discussion: Management of renal transplantation is a serious task which requires teamwork and cooperation as it can favorably change the patient's life quality when implemented successfully. In renal transplantation, achieving the post-transplantation survival rate (90-96%) reported in the literature requires detailed preoperative evaluation of patient along with appropriate intraoperative fluid administration and hemodynamic control.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 98%