Article Data

  • Views 2832
  • Dowloads 478

Original Research

Open Access

Anesthetic Management of Patients Undergoing Renal Transplantation: A Review of A Two-year Experience

  • Burhan Dost1
  • Muzeyyen Beldagli1
  • Cengiz Kaya1
  • Yasemin Burcu Ustun1
  • Sezgin Bilgin1
  • Ersin Koksal1
  • Yakup Bostancı2

1Department of Anesthesiology and Reanimation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey

2Department of Urology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey

DOI: 10.22514/sv.2020.16.0078 Vol.17,Issue 1,January 2021 pp.95-100

Published: 08 January 2021

*Corresponding Author(s): Burhan Dost E-mail: burhandost@hotmail.com

Abstract

Objectives: This study reviewed the anesthetic management procedures used for renal transplantation patients at a university hospital in Turkey over a two-year period. Areas of interest included preoperative status, fluid management, perioperative complications, and postoperative analgesia. Methods: A retrospective review of hospital records and information collected from all patients undergoing renal transplantation, performed at Ondokuz Mayıs University Hospital from 2018 to 2020, was conducted. Results: A total of 90 renal transplants were performed during the study time period. Of the patients undergoing renal transplantation, 44.4% were female and 55.6% were male. 52 patients were recipients of cadaveric transplants and 38 patients received kidneys from living, related donors. The duration of surgery and cold ischemic time were longer in the recipients of the cadaveric transplants (p < 0.05). Delayed graft function was statistically significantly higher in the kidney transplants obtained from the cadaveric donors than the living donors (p < 0.05). Conclusions: This study showed that anesthesia for renal transplantation is a safe and effective method if a selected range of drugs and techniques is used. Applying a well-planned standard anesthesia protocol and updating it periodically in line with the current literature will contribute to improving the quality of the outcomes renal transplantation surgery.

Keywords

Kidney transplantation, Anesthesia management, Delayed graft function, Analgesia, Hemodynamics

Cite and Share

Burhan Dost,Muzeyyen Beldagli,Cengiz Kaya,Yasemin Burcu Ustun,Sezgin Bilgin,Ersin Koksal,Yakup Bostancı. Anesthetic Management of Patients Undergoing Renal Transplantation: A Review of A Two-year Experience. Signa Vitae. 2021. 17(1);95-100.

References

[1] Held PJ, McCormick F, Ojo A, et al. A Cost-Benefit Analysis of Government Compensation of Kidney Donors. Am J Transplant. 2016;16:877-885.

[2] Rocha MJ, Ferreira S, Martins LS, et al. Cost analysis of renal replacement therapy by transplant in a system of bundled payment of dialysis. Clin Transplant. 2012;26:529-531.

[3] Wolfe RA, Ashby VB, Milford EL, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and re-cipients of a first cadaveric transplant. N Engl J Med. 1999;341:1725e30.

[4] Steinman TI, Becker BN, Frost AE, et al. Guidelines for the referral and management of patients eligible for solid organ transplantation. Transplantation. 2001;71:1189-1204.

[5] Ramos EL, Kasiske BL, Alexander SR, et al. The evaluation of candidates for renal transplantation. The current practice of U.S. transplant centers. Transplantation. 1994;57:490-497.

[6] Nemati E, Einollahi B, Pezeshki ML, et al. Does kidney transplantation with deceased or living donor affect graft survival? Nephro Urol Mon. 2014;6:e12182.

[7] Pence HH, Sert ÖZ, Bozkurt H, et al. The Effects of Laparoscopic Colon Surgery on Postoperative Renal Functions. Bakırköy Tıp Dergisi. 2019;15:193-197.

[8] Pilmore H, Dent H, Chang S, et al. Reduction in cardiovascular death after kidney transplantation. Transplantation. 2010;89:851e7.

[9] Schmid S, Jungwirth B. Anaesthesia for renal transplant surgery: an update. Eur J Anaesthesiol. 2012;29:552e8.

[10] Organ Procurement and Transplantation Network. Available at: https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/#.

[11] E. Nemati, B. Einollahi, M.L. Pezeshki, et al. Does kidney transplantation with deceased or living donor affect graft survival? Nephrourol Mon. 2014;5:e12182.

[12] Liyanage T, Ninomiya T, Jha V, et al. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet. 2015;385:1975-1982.

[13] Kaballo MA, Canney M, O’Kelly P, et al. A comparative analysis of survival of patients on dialysis and after kidney transplantation. Clin Kidney J. 2017;11:389e93.

[14] Pilmore H, Dent H, Chang S, et al. Reduction in cardiovascular death after kidney transplantation. Transplantation 2010;89:851e7.

[15] Schmid S, Jungwirth B. Anaesthesia for renal transplant surgery: an update. Eur J Anaesthesiol. 2012;29:552e8.

[16] Aniskevich S, Pai S-L, Shine TS. Anesthetic pharmacology for kidney transplantation. Curr Clin Pharmacol. 2015;10: 47e53.

[17] Kirvelä M, Olkkola KT, Rosenberg PH, et al. Pharmacokinetics of propofol and haemodynamic changes during induction of anaesthesia in uraemic patients. Br J Anaesth. 1992;68:178.

[18] Kar, S. K., Khurana, H. S., Ganguly, T. Anesthesia management of renal transplantation: an update. Anaesthesia, Pain & Intensive Care. 2019;22:383-392.

[19] Aniskevich S, Pai S-L, Shine TS. Anesthetic pharmacology for kidney transplantation. Curr Clin Pharmacol. 2015;10: 47e53.

[20] Kar, S. K., Khurana, H. S., Ganguly, T. Anesthesia management of renal transplantation: an update. Anaesthesia, Pain & Intensive Care, 2019;22:383-392.

[21] Lemmens H.J.M., Ingrande J. Anesthesia and Intraoperative Management of Renal Transplantation. Anesthesia and Perioperative Care for Organ Transplantation. Springer, New York, NY. 2017.

[22] Gyulai, F. (2018). End-Stage Renal Dısease—Patıent For Kıdney Trans-plant Blood Products. In: Straker T, Rajan S, editors. Anesthesiology: A Problem-Based Learning Approach, Oxford University Press; p155-165.

[23] Nishiyama T, Aibiki M, Hanaoka K. Inorganic fluoride kinetics and renal tubular function after sevoflurane anesthesia in chronic renal failure patients receiving hemodialysis. Anesth Analg. 1996;83:574.

[24] Hendrikus J M Lemmens. Anesthesia for kidney transplantation. In: UpToDate, Daniel C Brennan, Michael F O’Connor (Ed), UpToDate, Waltham, MA, 2020.

[25] Wierda JM, Kleef UW, Lambalk LM, et al. The pharmacodynamics and

pharmacokinetics of Org 9426, a new non-depolarizing neuromuscular blocking agent, in patients anaesthetized with nitrous oxide, halothane and fentanyl. Can J Anaesth. 1991;38:430-435.

[26] Jones PM, Turkstra TP. Urgent usage of sugammadex to treat residual neuromuscular blockade in the PACU. Anesth Analg. 2007;105:877-878.

[27] Adams DR, Tollinche LE, Yeoh CB, et al. Short-term safety and effectiveness of sugammadex for surgical patients with end-stage renal disease: a two-centre retrospective study. Anaesthesia. 2020;75:348-352.

[28] Deana, C., Barbariol, F., D’Incà, S. et al. SUGAMMADEX versus neostigmine after ROCURONIUM continuous infusion in patients undergoing liver transplantation. BMC Anesthesiol. 2020;20:70.

[29] Chaumont M, Racapé J, Broeders N, et al. Delayed Graft Function in Kidney Transplants: Time Evolution, Role of Acute Rejection, Risk Factors, and Impact on Patient and Graft Outcome. J Transplant. 2015;2015:163757.

[30] Hadimioglu N, Saadawy I, Saglam T, et al. The effect of different crystalloid solutions on acid-base balance and early kidney function after kidney transplantation. Anesth Analgesia. 2008;107:264e9.

[31] De Gasperi A, Narcisi S, Mazza E, et al. Perioperative fluid management in kidney transplantation: is volume overload still mandatory for graft function? Transplant Proc. 2006;38:807-809.

[32] Cavaleri M, Veroux M, Palermo F, et al. Perioperative Goal-Directed Therapy during Kidney Transplantation: An Impact Evaluation on the Major Postoperative Complications. J Clin Med. 2019;8:80.

[33] Della Rocca G, Vetrugno L, Tripi G, et al. Liberal or restricted fluid administration: are we ready for a proposal of a restricted intraoperative approach? BMC Anesthesiol. 2014;14:62.

[34] Hovaguimian F, Myles PS. Restrictive versus Liberal Transfusion Strategy in the Perioperative and Acute Care Settings: A Context-specific Systematic Review and Meta-analysis of Randomized Controlled Trials. Anesthesiology. 2016; 125:46.

[35] Makroo RN, Kakkar B, Chowdhry M, et al. Retrospective analysis of pe-rioperative transfusion requirements in living donor renal transplantation. Transfus Apher Sci. 2016;54:405e9.

[36] Yost CS, Niemann CU. Anesthesia for Abdominal Organ Transplantation. In: Miller’s Anesthesia. Philadelphia: Elsevier Churchill Livingstone; 2010. p. 2155-2184.

[37] Rohan, V.S., Taber, D.J., Patel, N., et al. Impact of a Multidisciplinary Multimodal Opioid Minimization Initiative in Kidney Transplant Recip-ients. Clin Transplant. 2020. doi:10.1111/ctr.14006.

[38] Koehntop DE, Rodman JH. Fentanyl pharmacokinetics in patients undergoing renal transplantation. Pharmacotherapy. 1997;17:746-752.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top