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Anesthesia kidney transplant

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https://www.readbyqxmd.com/read/29605864/robotic-kidney-autotransplantation-in-a-porcine-model-a-procedure-specific-training-platform-for-the-simulation-of-robotic-intracorporeal-vascular-anastomosis
#1
Ho Yee Tiong, Benjamin Yen Seow Goh, Edmund Chiong, Lincoln Guan Lim Tan, Anatharaman Vathsala
Robotic-assisted kidney transplantation (RKT) with the Da Vinci (Intuitive, USA) platform has been recently developed to improve outcomes by decreasing surgical site complications and morbidity, especially in obese patients. This potential paradigm shift in the surgical technique of kidney transplantation is performed in only a few centers. For wider adoption of this high stake complex operation, we aimed to develop a procedure-specific simulation platform in a porcine model for the training of robotic intracorporeal vascular anastomosis and evaluating vascular anastomoses patency...
March 31, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29593185/effectiveness-of-using-non-invasive-continuous-arterial-pressure-monitoring-with-clearsight-in-hemodynamic-monitoring-during-living-renal-transplantation-in-a-recipient-a-case-report
#2
Nami Kakuta, Yasuo M Tsutsumi, Chiaki Murakami, Yoko Sakai, Takuro Oyama, Asuka Kasai, Katsuyoshi Kume, Katsuya Tanaka
We investigated the effectiveness of the ClearSight system for hemodynamic management during kidney transplantation for a recipient. The recipient was to receive a kidney transplant from his mother under general anesthesia. We used continuous noninvasive finger-cuff-based monitoring of blood pressure, provided by the ClearSight system, and stroke volume variation to predict fluid responsiveness. We used of a balanced anesthetic technique and stringent monitoring standards to ensure a successful outcome for the patient...
2018: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/29497856/variation-in-frequency-of-intraoperative-arterial-central-venous-and-pulmonary-artery-catheter-placement-during-kidney-transplantation-an-analysis-of-invasive-monitoring-trends
#3
Alexander Nagrebetsky, Richard P Dutton, Jesse M Ehrenfeld, Richard D Urman
The rapidly increasing number of kidney transplantations warrants assessment of anesthesia care in this patient population. We explored the frequency of arterial catheter (AC), central venous catheter (CVC) and pulmonary artery catheter (PAC) placement during kidney transplantation in the USA using data from the National Anesthesia Clinical Outcomes Registry (NACOR) and assessed the between-facility variation in the frequency of catheter placement. We defined cases of kidney transplantation using Agency for Healthcare Research and Quality Clinical Classification Software...
March 2, 2018: Journal of Medical Systems
https://www.readbyqxmd.com/read/29409436/technique-of-ileobladder-and-kidney-transplant-in-rats-and-pigs
#4
Mehmet Haberal, Mahir Kirnap, Oruc N Gokce, Didem Bacanli, Zeynep Ersoy, Mirbek Bayzakov, Adnan Torgay, Handan Ozdemir, Remzi Erdem
OBJECTIVES: Kidney transplant is the best choice for treatment of patients with advanced chronic renal disease. However, small, poorly compliant, and unstable bladders can result in major problems for patients. Here, we aimed to develop and evaluate a new ileobladder model. MATERIALS AND METHODS: Fifteen rats (250-300 g) and 5 pigs (~100 kg) were cared for according to institutional and published guidelines. After general anesthesia, laparotomy was done through midline incision...
February 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29383330/bilateral-prone-percutaneous-nephrolithotomy-under-epidural-in-candidate-for-lung-transplant-case-report-and-review-of-literature
#5
Ricardo Manuel de Oliveira Soares, Alexander Paul Glaser, Jason Evan Cohen, Obianuju Okocha, Robert Brewster Nadler
Background: Percutaneous nephrolithotomy (PCNL) is a procedure typically performed under general anesthesia (GA); however, many patients might be considered unfit for GA and locoregional anesthesia is their only chance to have the procedure done. Case Presentation: A 60-year-old Middle-Eastern female with end-stage lung disease underwent evaluation for lung transplant; she was found to have severe restrictive pattern on steroid and continuous oxygen therapy, pulmonary hypertension with dilated right ventricle, chronic anemia, and asthma...
2018: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29221922/pediatric-percutaneous-nephrostomy-a-multicenter-experience
#6
Sphoorti Shellikeri, Robert Daulton, Madeleine Sertic, Bairbre Connolly, Mark Hogan, Francis Marshalleck, Anne Marie Cahill
PURPOSE: To analyze technique, outcomes, and complications of a large series of pediatric percutaneous nephrostomy (PCN) procedures performed at 4 tertiary pediatric centers. MATERIALS AND METHODS: Retrospective multicenter study of PCNs performed during an 11-year period. Six hundred seventy-five PCNs were performed on 441 patients (median age: 4 y, range: 1 d-18 y, median weight: 17 kg, range: 0.7-112 kg); 31% were younger than 1 year. The most frequent indications for PCN procedures included hydronephrosis (57%), calculus (14%), and infection (12%)...
March 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29131005/a-review-of-anesthetic-effects-on-renal-function-potential-organ-protection
#7
Negar Motayagheni, Sheshanna Phan, Crystal Eshraghi, Ala Nozari, Anthony Atala
BACKGROUND: Renal protection is a critical concept for anesthesiologists, nephrologists, and urologists, since anesthesia and renal function are highly interconnected and can potentially interfere with one another. Therefore, a comprehensive understanding of anesthetic drugs and their effects on renal function remains fundamental to the success of renal surgeries, especially transplant procedures. Some experimental studies have shown that some anesthetics provide protection against renal ischemia/reperfusion (IR) injury, but there is limited clinical evidence...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29050500/prophylactic-fibrinogen-decreases-postoperative-bleeding-but-not-acute-kidney-injury-in-patients-undergoing-heart-transplantation
#8
Alireza Jahangirifard, Zargham Hossein Ahmadi, Farah Naghashzadeh, Babak Sharif-Kashani, Farin Rashid-Farokhi, Ali Afshar, Reyhaneh Yamini-Sharif, Yousef Rezaei
The present study is the premier clinical attempt to scrutinize the practicability of prophylactic fibrinogen infusion in patients undergoing heart transplantation (HT). A total of 67 consecutive patients who had undergone HT between January 2012 and December 2014 were assessed. After exclusion of some patients, 23 patients were given preoperative 2 g fibrinogen concentrate over a period of 15 minutes after the termination of cardiopulmonary bypass pump and complete reversal of heparin, and 30 patients were not given...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28868984/the-new-kidney-donor-allocation-system-and-implications-for-anesthesiologists
#9
Srikanth Sridhar, Sara Guzman-Reyes, Sam D Gumbert, Semhar J Ghebremichael, Angelina R Edwards, Mark J Hobeika, Wasim A Dar, Evan G Pivalizza
Given potential disparity and limited allocation of deceased donor kidneys for transplantation, a new federal kidney allocation system was implemented in 2014. Donor organ function and estimated recipient survival in this system has implications for perioperative management of kidney transplant recipients. Early analysis suggests that many of the anticipated goals are being attained. For anesthesiologists, implications of increased dialysis duration and burdens of end-stage renal disease include increased cardiopulmonary disease, challenging fluid, hemodynamic management, and central vein access...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28719391/pediatric-and-congenital-hand-transplantation
#10
Sandra Amaral, L Scott Levin
PURPOSE OF REVIEW: We review the approach and challenges associated with pediatric hand transplantation, including new knowledge gleaned from our recent case of bilateral hand-forearm transplantation in an 8-year old child. RECENT FINDINGS: Bilateral heterologous hand-forearm transplantation was performed in a child with a prior kidney transplant in July 2015. The initial surgery necessitated a large team of experts in microvascular surgery, transplant surgery, orthopedics and plastic surgery as well as pediatric anesthesia...
July 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28340810/comparison-of-two-different-inhalation-anesthetics-on-grafted-kidney-function-in-patients-undergoing-renal-transplantation-surgery-desflurane-or-sevoflurane
#11
COMPARATIVE STUDY
M S Karadeniz, H S Ciftci, T Tefik, O Mammadov, H Yazıcı, I Nane, A Turkmen, F Oguz, K M Tugrul
BACKGROUND: Anesthetic management of patients during renal transplantation is vitally important for ensuring proper functioning of kidneys that have undergone ischemia-reperfusion damage. The goal of this prospective study was to compare the effects of 2 different inhalation agents (sevoflurane and desflurane) on grafted kidney function in renal transplantation surgery. METHODS: Sixty-five patients who were scheduled for living donor renal transplantation were enrolled in the study...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28298791/amyloidosis-and-anesthesia
#12
Zara Wani, Dev Kumar Harkawat, Meenaxi Sharma
AIM: The aim of this article is to provide a view of amyloidosis and discuss implications for the anesthetic management of patients with this condition. MATERIAL AND METHOD: Urine samples from patients with plasma cell dyscrasias were obtained from a urine bank that gathers urine samples from patients who gave research use consent for specimens that would otherwise be considered waste. RESULTS: Patients with amyloidosis may present to the anesthesiologist for procedures relating to diagnosis, surgery relating to the underlying condition (e...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298768/comparative-study-of-the-effect-of-intravenous-paracetamol-and-tramadol-in-relieving-of-postoperative-pain-after-general-anesthesia-in-nephrectomy-patients
#13
Venkata Sesha Sai Krishna Manne, Srinivasa Rao Gondi
AIM: The aim of this study was to compare the effect of intravenous paracetamol and tramadol in relieving of postoperative pain after general anesthesia for nephrectomy in prospective donor patients for kidney transplantation. MATERIALS AND METHODS: A randomized study was conducted on 100 adult patients scheduled for nephrectomy aged from 35 to 55 years of both sexes and divided into two groups and were administered intravenous paracetamol and tramadol for postoperative pain relief and assessed with visual analog scale score and variations in vital parameters to assess extent of pain relief...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28072739/risk-factors-and-outcomes-associated-with-a-higher-use-of-inotropes-in-kidney-transplant-recipients
#14
Jae Moon Choi, Jun-Young Jo, Jae-Won Baik, Sooyoung Kim, Chan Sik Kim, Sung-Moon Jeong
Preservation of adequate perfusion pressures to the graft is a main focus of intraoperative management during kidney transplantation. We undertook this study to investigate the incidence of the higher use of inotropes in kidney transplant recipients and identify the patient outcomes and preoperative and intraoperative variables related to this.We retrospectively analyzed 1053 patients who underwent kidney transplantation at Asan Medical Center between January 2006 and February 2012, stratified by their inotropic score ([dopamine] + [dobutamine] + [epinephrine × 100] + [norepinephrine × 100]) <7 versus ≥7, wherein all doses are expressed as μg/kg/min...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27932148/low-dose-spinal-block-with-continuous-epidural-infusion-for-renal-transplantation-in-a-patient-with-alport-syndrome-a-case-report
#15
F Gobbi, G Sales, P Bretto, P P Donadio, L Brazzi
OBJECTIVE: We aim to describe management of a patient receiving renal transplantation for chronic renal failure due to Alport syndrome with low dose of intrathecal bupivacaine and continuous epidural infusion of local anesthetic. CASE REPORT: A 38-years-old man with chronic renal failure secondary to Alport syndrome underwent kidney transplantation. Because of a high risk of respiratory and cardiovascular complications related to the patient's baseline lung disease and abnormalities in heart conduction, we selected combined spinal-epidural anesthesia...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27746573/anesthesia-for-bench-surgery
#16
S Sachin, M C Rajesh, E K Ramdas
Surgical removal of the kidney tumor outside the body, (ex vivo renal bench surgery) followed by auto transplantation is an emerging and often done procedure to reconstruct the urinary tract. It possesses immense challenges to both the anesthesiologists and the surgeons. The risks are multiplied if you are performing the surgery on a solitary functioning kidney. Here, we are describing the anesthetic management of 70-year-old male post nephrectomy patient undergoing renal auto transplantation by bench surgery...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27595164/review-of-remote-ischemic-preconditioning-from-laboratory-studies-to-clinical-trials
#17
Vesa Anttila, Henri Haapanen, Fredrik Yannopoulos, Johanna Herajärvi, Tuomas Anttila, Tatu Juvonen
In remote ischemic preconditioning (RIPC) short periods of non-lethal ischemia followed by reperfusion of tissue or organ prepare remote tissue or organ to resist a subsequent more severe ischemia-reperfusion injury. The signaling mechanism of RIPC can be humoral communication, neuronal stimulation, systemic modification of circulating immune cells, and activation of hypoxia inducible genes. Despite promising evidence from experimental studies, the clinical effects of RIPC have been controversial. Heterogeneity of inclusion and exclusion criteria and confounding factors such as comedication, anesthesia, comorbidities, and other risk factors may have influenced the efficacy of RIPC...
October 2016: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/27375736/falsely-increased-bispectral-index-values-by-convective-air-warming-system-during-kidney-transplantation
#18
Se Hun Kim, Byeong-Cheol Lee, Yong Han Kim
Bispectral index (BIS) is a reliable parameter for measuring depth of hypnotic level during anesthesia. Convective air warming system is an effective equipment to maintain normothermia during operation. We report falsely elevated BIS value due to convective air warming system while undergoing kidney transplantation.
May 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27285002/anesthetic-considerations-for-the-parturient-after-solid-organ-transplantation
#19
REVIEW
Daria M Moaveni, Jennifer H Cohn, Katherine G Hoctor, Ryan E Longman, J Sudharma Ranasinghe
Over the past 40 years, the success of organ transplantation has increased such that female solid organ transplant recipients are able to conceive and carry pregnancies successfully to term. Anesthesiologists are faced with the challenge of providing anesthesia care to these high-risk obstetric patients in the peripartum period. Anesthetic considerations include the effects of the physiologic changes of pregnancy on the transplanted organ, graft function in the peripartum period, and the maternal side effects and drug interactions of immunosuppressive agents...
August 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27185722/anesthetic-management-of-donor-nephrectomy-for-a-recipient-with-history-of-malignant-hyperthermia-avoiding-a-transferred-trigger
#20
Jacob Schaff, Robert Maniker
We describe a case of living unrelated renal transplantation from a non-malignant hyperthermia (MH) susceptible donor to an MH-susceptible recipient, along with its intraoperative and perioperative considerations. The renal transplant recipient reported a personal history of MH requiring intensive care unit admission. A nontriggering anesthetic was therefore chosen for the unrelated donor to avoid possible triggering via the transplanted kidney to the MH-susceptible recipient. This case provides a unique opportunity to review the concepts of antigen transfer related to transplant anesthesia, as well as the importance of communication among anesthesia and surgical teams to promote patient safety...
June 2016: Journal of Clinical Anesthesia
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