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Abstract

Our service evaluation demonstrated that enhanced recovery benefits both types of renal transplant (living and deceased grafts) procedures, with excellent patient satisfaction and reduction of hospital length of stay.

Abdominal Organ Transplantation: Noteworthy Literature in 2018

“…The authors extrapolated the estimated cost savings of their ERAS protocol to £2052 per LRKT and £2565 per DDKT. 27 Although this was a small, singlecenter study with limited data on morphine requirements in the historical cohort, the results demonstrate the feasibility and potential value of implementing an enhanced recovery program for kidney transplant recipients.…”

“…14,26 Enhanced Recovery After Surgery. Halawa et al 27 described their experience implementing an enhanced recovery protocol for 286 kidney transplant recipients. The protocol was utilized in 135 patients, including 60 living related kidney transplants (LRKTs) and 75 DD kidney transplants (DDKTs).…”

“…The other 151 patients underwent a traditional recovery protocol (85 LRKTs, 66 DDKTs). 27 The Enhanced Recovery After Surgery (ERAS) protocol included preoperative nutrition with carbohydrate drinks up to 2 hours before surgery (diabetics were excluded), intraoperative fluid therapy guided by transesophageal Doppler (to decrease CVC placement), preoperative intrathecal morphine and transversus abdominal plane block for perioperative pain management, and morphine patient-controlled analgesia on postoperative day 1, followed by oral pain medication. Early oral intake was encouraged in the first few hours following surgery, with discontinuation of intravenous fluids within 24 hours.…”

Implementing enhanced recovery pathways to improve surgical outcomes

“…[ 9 ] In another study conducted in renal transplant patients, patient-controlled analgesia morphine requirements were significantly reduced after surgery in the ERAS group versus the non-ERAS group. [ 10 ] Despite limiting opioid usage preoperatively and decreased pain scores and the need for opioids after surgery, the culture of prescribing pain medications postoperatively after discharge has remained unchanged. [ 11 ] The reason for this may be that the prescribing practices for opioids after surgery are deeply entrenched and not as easily changed as perioperative care practices.…”

Utility of central venous pressure measurement in renal transplantation: Is it evidence based?

“…The study documented a significantly lower amount of IV fluids used with the new technique, not only that but also there was a significantly shorter ICU stay, and a non-significant shorter hospital stay[ 17 ]. These non-invasive tools were used successfully as a part of enhanced recovery programs in kidney transplantation to improve patient outcomes and speed up patient’s recovery after surgery[ 18 ].…”