Medicina Fluminensis, Vol. 56 No. 4, 2020.
Review article
https://doi.org/10.21860/medflum2020_245222
Specificities of anesthesia management for kidney transplantation
Lara Valenčić
orcid.org/0000-0001-6700-1380
; Klinika za anesteziologiju, intenzivnu medicinu i liječenje boli, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Ivana Koraca Chinchella
; Klinika za anesteziologiju, intenzivnu medicinu i liječenje boli, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Kazimir Juričić
; Klinika za anesteziologiju, intenzivnu medicinu i liječenje boli, Klinički bolnički centar Rijeka, Rijeka, Hrvatska
Abstract
Kidney transplantation represents the best method for treating end-stage renal disease. The procedure is led by a team involving a nephrologist, a urologist, an anesthesiologist and a family medicine doctor whose cooperation is an indispensable part of patient care. The anesthesiologist encounters numerous patient’s comorbidities with a complex medical history and a wide range of medications. The emphasis is set on cardiovascular diseases which are the most common cause of mortality in this group of patients. The incidence of hematological, metabolic, respiratory and endocrine diseases is common, and it is extremely important to optimize the patient’s general condition prior to surgery. Kidney transplantation usually cannot be planned so it should be treated as an emergency, increasing the risk of complications. During the procedure that is performed under general, balanced anaesthesia, the role of the anesthesiologist is to know pharmacokinetics and pharmacodynamics of the drugs. Maintenance of blood pressure during anesthesia ensures an adequate kidney transplant perfusion. Early antibiotic and immunosuppressive therapy with satisfactory analgesia is important. In the postoperative course, early identification and prevention of possible complications is necessary to prevent unwanted kidney transplant rejection.
Keywords
end-stage renal disease; kidney transplantation; maintenance of anesthesia; preoperative preparation; postoperative care
Hrčak ID:
245222
URI
Publication date:
1.12.2020.
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