AI Article Synopsis
- Anesthesia for kidney transplantation should optimize blood flow to the transplanted organ while managing blood count changes due to hemodilution to avoid complications associated with ischemia-reperfusion syndrome.
- A study of 86 patients showed no significant relationship between fluid-induced hemodilution and delayed graft failure, indicating that fluid management may not impact transplant outcomes as previously thought.
- Proper preoperative preparation, including anemia treatment, is crucial to prevent post-transplant anemia and its potential complications, highlighting the need for careful patient management before surgery.
Article Abstract
Background: Anesthesia in patients undergoing kidney transplantation (KTx) should be aimed at creating optimal hemodynamic conditions for the newly implanted kidney. Changes in of blood count, caused mainly by intraoperative hemodilution, may adversely affect the perioperative course by strengthening the pathologic mechanisms of ischemia-reperfusion syndrome.
Methods: A total of 86 patients (mean age: 49.4 ± 14.0 years, 66% men) with end-stage renal disease who underwent KTx between 2012 and 2015 were included in this retrospective study. Our aim was to assess the hemoglobin level and the effect of fluctuations caused by the implemented fluid therapy on graft function and the occurrence of delayed graft failure.
Results: There was no difference in baseline characteristics, indication for transplantation, and surgical technique used among study population. Among the whole observation group, no correlation was found between fluid therapy causing hemodilution with a decrease in hemoglobin concentration and the occurrence of delayed graft failure.
Conclusions: In our observations, we paid special attention to the problem of hemodilution in patients undergoing KTx. It is important to emphasize the importance of proper preparation of the patient for KTx by earlier implementation of anemia therapy, thus preventing exacerbation of anemia in the postoperative period, especially because the perioperative use of blood products is associated with numerous complications and a worse prognosis for the newly implanted kidney.
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| http://dx.doi.org/10.1016/j.transproceed.2020.01.095 | DOI Listing |
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