Korean J Anesthesiol.  1997 Nov;33(5):944-952. 10.4097/kjae.1997.33.5.944.

Clinical Analysis of 200 Renal Transplantations

• Ryu KH
• Kim YS
• Cho SD
• Song NW

• KMID: 2154492
• DOI: http://doi.org/10.4097/kjae.1997.33.5.944

Abstract

BACKGROUND: Since the initial report on anesthesia for the renal transplantation from Peter Bent Brighan Hospital in 1962, the anesthesia for kidney transplantation has been reviewed and discussed by many authors. We have performed 200 renal transplantations from August 1990 to October 1996. No cadaveric donor was used and all except two cases was the first graft.
METHODS
Anesthetic procedures in the recipients were as follows; 1) The recipient was dialysed within 24 hrs prior to operation. 2) Premedication was done as glycopyrrolate and fentanyl, or glycopyrrolate and diazepam. 3) Thiopental and vecuronium, or thiopental and succinylcholine were used for anesthetic induction. 4) N2O-O2-relaxant (vecuronium) with halothane or isoflurane were used for maintenance. 5) Neostigmine or pyridostigmine were also used to antagonize against the relaxant. 6) CVP was maintained around 10~17 cmH2O.
RESULTS
The results were as follows; 1) The mean ages of donors and recipients were 35.3 and 37.4, respectively. The ratio of male to female of donors and recipients was 1.6 : 1 and 1.6 : 1, respectively. 2) One hundred and ten cases (55.0%) were living unrelated donors and 90 cases (45.0%) were living related donors. 3) Overall graft and patient survival rate was 96.9 and 98.0 at 1 year, 94.1 and 95.1 at 3 years.
CONCLUSIONS
Most patients with renal failure have several common problems that are of significance to anesthesiologists, including anemia, bleeding tendency, electrolyte imbalance, acidosis, hypertension, hyper- or hypovolemia, and previous therapy with steroids and immunosuppressants, etc. Therefore anesthesiologists should keep in mind the risk factors above mentioned for the anesthetic management of patients with renal failure.

Keyword

Anesthesia, perioperative evaluation; Kidney, transplantation

MeSH Terms

Acidosis
Anemia
Anesthesia
Cadaver
Diazepam
Female
Fentanyl
Glycopyrrolate
Halothane
Hemorrhage
Humans
Hypertension
Hypovolemia
Immunosuppressive Agents
Isoflurane
Kidney Transplantation*
Male
Neostigmine
Premedication
Pyridostigmine Bromide
Renal Insufficiency
Risk Factors
Steroids
Succinylcholine
Survival Rate
Thiopental
Tissue Donors
Transplants
Unrelated Donors
Vecuronium Bromide
Diazepam
Fentanyl
Glycopyrrolate
Halothane
Immunosuppressive Agents
Isoflurane
Neostigmine
Pyridostigmine Bromide
Steroids
Succinylcholine
Thiopental
Vecuronium Bromide