medigraphic.com

2017, Number 3

<< Back Next >>

Rev Mex Anest 2017; 40 (3)

Anesthetic protocol for renal transplant of the Hospital of Specialties of the Centro Medico Nacional Siglo XXI

Fernández-García JO, Cervantes-Maldonado HE, Zarazúa-Juárez M, Reyes-Rodríguez DM, Castellanos-Olivares A

Language: Spanish
References: 38
Page: 176-189
PDF size: 238.14 Kb.


ABSTRACT

Chronic end-stage renal disease is the end result of evolutionary nephropathies that left their natural evolution leading to death. There are currently three substitute actions for the management of this disease: peritoneal dialysis, hemodialysis and renal transplantation, the first two are of a palliative nature, with a very high social and economic cost. Not so renal transplantation, which offers a greater perspective of rehabilitation and social integration. In Mexico the first kidney transplant was performed on October 22, 1963 at the Centro Médico Nacional belonging to the Instituto Mexicano del Seguro Social; since then and to date, about 3,000 kidney transplants have been successfully performed in this unit. The anesthetic management of these patients is a challenge due to the systemic repercussions of kidney disease and other associated comorbidities. Renal transplantation is an interdisciplinary field where the anesthesiologist’s role plays a crucial role throughout the critical perioperative phase. Advances in the management of the patient undergoing transplantation and the better preparation of these for surgery have made it a successful and widely disseminated procedure. However, the anesthetic management can vary between the different hospital centers according to the available human and material resources and the type of population. Therefore, it is extremely important to have an anesthetic protocol according to the characteristics and needs of each institution. The present work describes the anesthetic protocol for renal transplant of the Hospital de Especilidades del Centro Médico Nacional Siglo XXI.


REFERENCES

  1. Goicoechea MA, Gorostidi M, Marín R. Guías SEN: Riñón y enfermedad cardiovascular. Nefrología. 2004; 24: 27-34.

  2. K/DOQI. Clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002; 39: 266.

  3. Pfeffer MA, Burdmann EA, Chen CY, Cooper ME, de Zeeuw D, Eckardt KU, et al. A trial of darbepoetin alfa in type 2 diabetes and chronic kidney disease. N Engl J Med. 2009; 361: 2019-2032.

  4. USRDS System. USRDS 2010 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. National Institutes of Health 2010, National Institute of Diabetes and Digestive and Kidney Diseases.

  5. CENATRA. Estado Actual de Donación y Trasplantes en México 2011; 12-26.

  6. Andrews PA. Renal transplantation. Clinical review. BMJ. 2002; 324: 530-534.

  7. Beltrán JJ, Monsalve C. Protocol intraoperatori d’ Anestèsia en Trasplantament Renal. Hospital Universitari Clínic Barcelona. 2010; 1-8.

  8. Drury N. Anaesthesia for renal transplantation. ATOTW 2010; 174: 1-6.

  9. Villegas AF, Gracida JC, Castellanos OA, Rangel MM. Anestesia para trasplante renal: experiencia de 20 años. Rev Mex Anest. 2012; 35: 167-173.

  10. Fernández JO, Vásquez PI, Villegas F, Castellanos A. Evaluación hemodinámica de dos agentes anestésicos inhalatorios para cirugía de trasplante renal. Rev Mex Anest. 2015; 38-S1: S293-S296.

  11. Andrews PA, Burnapp L, Manas D, Bradley JA, Dudley C; British Transplantation Society, et al. Summary of the British Transplantation Society/Renal Association UK Guidelines for Living Donor Kidney Transplantation. Transplantation. 2012; 93: 666-673.

  12. Secretaría de Salud. Reglamento de la Ley General de Salud en Materia de Trasplantes. Diario Oficial de la Federación, 26 de marzo de 2014.

  13. Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof EL, Fleischmann KE, et al. ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery. J Am Coll Cardiol. 2007; 50: 1707-1732.

  14. Brenden CK, Hollander JE, Guss D, McCullough PA, Nowak R, Green G, et al. Gray zone BNP levels in heart failure patients in the emergency department: results from the Rapid Emergency Department Heart Failure Outpatient Trial (REDHOT) multicenter study. Am Heart J. 2006; 151: 1006-1011.

  15. Rabbat CG, Treleaven DJ, Russell JD, Ludwin D, Cook DJ. Prognostic value of myocardial perfusion studies in patients with end-stage renal disease assessed for kidney or kidney-pancreas transplantation: a meta-analysis. J Am Soc Nephrol. 2003; 14: 431-439.

  16. Toivonen HJ. Anaesthesia for patients with a transplanted organ. Acta Anaesthesiol Scand. 2000; 44: 812-833.

  17. Yigla M, Nakhoul F, Sabag A, Tov N, Gorevich B, Abassi Z, et al. Pulmonary hypertension in patients with end – stage renal disease. Chest. 2003; 123: 1577-1582.

  18. Colomina MJ, Guilabert P. Transfusión según cifras de hemoglobina o de acuerdo con objetivos terapéuticos. Rev Esp Anestesiol Reanim. 2016; 63: 65-68. http://dx.doi.org/10.1016/j.redar.2015.10.001

  19. Obrador GT, Macdougall IC. Effect of Red Cell Transfusions on Future Kidney Transplantation. Clin J Am Soc Nephrol. 2013; 8: 852-860.

  20. Opelz G, Graver B, Mickey MR, Terasaki PI. Lymphocytotoxic antibody responses to transfusions in potential kidney transplant recipients. Transplantation. 1981; 32: 177-183.

  21. Opelz G, Vanrenterghem Y, Kirste G, Gray DW, Horsburgh T, Lachance JG, et al. Prospective evaluation of pretransplant blood transfusions in cadaver kidney recipients. Transplantation. 1997; 63: 964-967.

  22. Cofan F, Torregrosa JV. Manejo clínico del paciente trasplantado renal de donante vivo. Arch Esp Urol. 2005; 58 (6): 531-536.

  23. Sood J, Vohra V. Anesthesia for trasplant surgery, Jaypee Brothers Medical Publishers, India 2014.

  24. Qureshi F, Rabb H, Kasiske BL. Silent acute rejection during prolonged delayed graft function reduces kidney allograft survival. Transplantation. 2002; 74 (10): 1400-1404.

  25. Lemmens HJ. Kidney transplantation: recent developments and recommendations for anesthetic management. Anesthesiology Clin North America. 2004; 22: 651-662.

  26. Smith CE, Hunter JM. Anesthesia for renal transplantation: relaxants and volatiles. Int Anesthesiol Clin. 1995; 33: 69-92.

  27. Gelb AW, Freeman D, Robertson KM, Zhang C. Isoflurane alters the kinetics of oral cyclosporine. Anesth Analg. 1991; 72: 801-804.

  28. Litz RJ, Hubler M, Lorenz W, Meier VK, Albrecht DM. Renal responses to desflurane and isoflurane in patients with renal insufficiency. Anesthesiology. 2002; 97: 1133-1136.

  29. Roscoe AK, Christensen JD, Lynch C. Isoflurane, but not halothane, induces protection of human myocardium via adenosine A1 receptors and adenosine triphosphate-sensitive potassium channels. Anesthesiology. 2000; 92: 1692-1701.

  30. American Society of Anesthesiologists Task Force on Intraoperative Awareness. Practice advisory for intraoperative awareness and brain function monitoring: a report by the american society of anesthesiologists task force on intraoperative awareness. Anesthesiology. 2006; 104: 847-864.

  31. Conradie S, Coetzee A, Coetzee J. Anesthetic modulation of myocardial ischemia and reperfusion injury in pigs: comparison between halothane and sevoflurane. Can J Anaesth. 1999; 46: 71-81.

  32. Kharasch ED, Frink Jr EJ, Zager R, Bowdle TA, Artru A, Nogami WM. Assessment of low-flow sevoflurane and isoflurane effects on renal function using sensitive markers of tubular toxicity. Anesthesiology. 1997; 86: 1238-1253.

  33. Feltracco P, Ori C. Anesthetic management of living transplantation. Minerva Anestesiol. 2010; 76: 525-533.

  34. Dart AB, Mutter TC, Ruth CA, Taback SP. Hydroxyethyl starch (HES) versus other fluid therapies: effects on kidney function. Cochrane Database of Systematic Reviews. 2010; (1): CD007594. doi: 10.1002/14651858.CD007594.pub2.

  35. Myburgh JA, Mythen MG. Resuscitation fluids. N Engl J Med. 2013; 369: 1243-1251.

  36. Chappell D, Jacob M, Hofmann-Kiefer K, Conzen P, Rehm M. A rational approach to perioperative fluid management. Anesthesiology. 2008; 109: 723-740.

  37. Raghunathan K, Murray PT, Beattie WS, Lobo DN, Myburgh J, Sladen R, et al. Choice of fluid in acute illness: what should be given? An international consensus. Br J Anaesth. 2014; 113 (5): 772-783.

  38. Othman MM, Ismael AZ, Hammouda GE. The impact of timing of maximal crystalloid hydration on early graft function during kidney transplantation. Anesth Analg. 2010; 110: 1440-1446.




2020     |     www.medigraphic.com