Comparison of Two Different Inhalation Anesthetics on Grafted Kidney Function in Patients Undergoing Renal Transplantation Surgery: Desflurane or Sevoflurane?

Karadeniz, Meltem Savran; Çiftçi, Hayriye Şentürk; Tefik, Tzevat; Mammadov, Orkhan; Yazıcı, Halil; Nane, I.; Türkmen, Aydın; Oğuz, Fatma; Tuğrul, Kamil

doi:10.1016/j.transproceed.2017.01.014

Cited by 7 publications

(5 citation statements)

References 23 publications

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“…In animal studies, sevoflurane has shown potential nephrotoxic effects linked to its metabolites, compound A, and fluoride ions. However, research conducted in humans has not provided evidence of any harmful effects on renal function [ 21 , 22 ]. Desflurane, isoflurane, and propofol can be used for anesthesia [ 7 ].…”

Section: Intraoperative Managementmentioning

confidence: 99%

Considerations regarding anesthesia for renal transplantation

Kim,

Jung

2024

Anesth Pain Med

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Renal transplantation is a complex surgical procedure requiring meticulous anesthetic planning to ensure patient safety and optimal graft function. In this comprehensive review, we examined various aspects of anesthesia management during renal transplantation, including preoperative, intraoperative, and postoperative care. Preoperative optimization involves the identification and management of risks to mitigate perioperative complications. Treatment with erythropoiesis-stimulating agents is recommended to correct anemia in transplant recipients with hemoglobin levels below 9–10 g/dl. Intraoperative management focuses on hemodynamic monitoring, maintenance of intravascular volume, and careful selection of anesthetic techniques. Neuromuscular monitoring and the appropriate use of neuromuscular blocking and reversal agents are considered essential. Further, hemodynamic goals include maintaining the mean arterial pressure within the range of 80–110 mmHg. In addition, attention should be paid to perioperative glycemic control, temperature management, and diuretic use. In postoperative management, multimodal analgesia and the prevention of postoperative delirium contribute to optimal recovery. The implementation of enhanced recovery after surgery principles can further improve outcomes. Collaborative efforts among surgical teams, anesthesiologists, and healthcare professionals are crucial for achieving successful renal transplantation outcomes.

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Section: Intraoperative Managementmentioning

confidence: 99%

Considerations regarding anesthesia for renal transplantation

Kim,

Jung

2024

Anesth Pain Med

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“…Another, more detailed study evaluated hemodynamics, creatinine, glomerular filtration rate, and inflammatory factors and supported the finding that desflurane had no adverse effect on transplanted kidney function. 103 In comparisons between desflurane and sevoflurane, desflurane may be more beneficial in renal transplantation in regulatory T cells (Tregs). 104 And, in studies of pancreas transplantation, desflurane significantly increased early graft survival and reduced post-transplant clinical outcomes associated with IRI.…”

Section: Desflurane In Organ Transplantationmentioning

confidence: 99%

Myocardial protection by desflurane: from basic mechanisms to clinical applications

Han

Jun

2023

Journal of Cardiovascular Pharmacology

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Coronary heart disease (CHD) is an affliction that is common and has an adverse effect on patients' quality of life and survival while also raising the risk of intraoperative anesthesia. Mitochondria are the organelles most closely associated with the pathogenesis, development and prognosis of CHD. Ion abnormalities, an acidic environment, the production of reactive oxygen species, and other changes during abnormal myocardial metabolism cause the opening of mitochondrial permeability transition pores, which disrupts electron transport, impairs mitochondrial function, and even causes cell death. Differences in reliability and cost-effectiveness between desflurane and other volatile anesthetics are minor, but desflurane has shown better myocardial protective benefits in the surgical management of patients with coronary artery disease. The results of myocardial protection by desflurane are briefly summarized in this review, and biological functions of the mitochondrial permeability transition pore, mitochondrial electron transport chain, reactive oxygen species, atp-dependent potassium channels, G protein-coupled receptors, and protein kinase C are discussed in relation to the protective mechanism of desflurane. This article also discusses the effects of desflurane on patient hemodynamics, myocardial function, and postoperative parameters during coronary artery bypass grafting. Although there are limited and insufficient clinical investigations, they do highlight the possible advantages of desflurane and offer additional suggestions for patients.

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“…Inorganic fluorides were responsible for renal failure following methoxyflurane anaesthesia. It has been suggested that sevoflurane may cause renal impairment, but the majority of other studies did not confirm sevoflurane nephrotoxicity [ 86 , 87 ]. Desflurane is considered a safe agent.…”

Section: Intraoperative Carementioning

confidence: 99%

Anaesthetic Approach to Enhanced Recovery after Surgery for Kidney Transplantation: A Narrative Review

Jaszczuk

Natarajan

Papalois

2022

JCM

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Enhanced recovery after surgery (ERAS) protocols are designed to reduce medical complications, the length of hospital stays (LoS), and healthcare costs. ERAS is considered safe and effective for kidney transplant (KTx) surgery. KTx recipients are often frail with multiple comorbidities. As these patients follow an extensive diagnostic pathway preoperatively, the ERAS protocol can ideally be implemented at this stage. Small singular changes in a long perioperative pathway can result in significant positive outcomes. We have investigated the current evidence for an ERAS pathway related to anaesthetic considerations in renal transplant surgery for adult recipients.

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Comparison of Two Different Inhalation Anesthetics on Grafted Kidney Function in Patients Undergoing Renal Transplantation Surgery: Desflurane or Sevoflurane?

Cited by 7 publications

References 23 publications

Considerations regarding anesthesia for renal transplantation

Considerations regarding anesthesia for renal transplantation

Myocardial protection by desflurane: from basic mechanisms to clinical applications

Anaesthetic Approach to Enhanced Recovery after Surgery for Kidney Transplantation: A Narrative Review

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