sevoflurane kidney transplant

UNLABELLED: Different inhalational anesthetics have various hemodynamic effects, either on the global circulation or on kidney perfusion. These drugs are also different concerning their potential for renal toxicity. The potential influence of the choice of the halogenated anesthetion in the outcome of kidney transplantation has not been previously studied, which was the purpose of this observational study. METHODS: We examined the hospital records and anesthesiology charts of 200 patients undergoing renal transplantation using general anesthesia...

BACKGROUND: The main metabolic pathway for defluorination of sevoflurane in the liver produces inorganic fluoride (Fl). The metabolism and effect of sevoflurane on the kidney is not clear during anhepatic phase in liver transplantation. The goal of the present study was to investigate the metabolism and renal effect of sevoflurane by measuring plasma and urine inorganic fluoride, urinary N-acetyl-glucosaminidase (NAG), and plasma creatinine levels in patients undergoing liver transplantations...

The nephrotoxicity of anaesthesia remains a current question with the use of low-flow sevoflurane anaesthesia, although the issue of clinically relevant toxicity in patients with renal disease has not been evaluated. With regard to kidney transplantation, the type of fluid administered for volume management of organ donors appears crucial to improve postoperative recovery of renal function.

In a case of liver transplantation, sevoflurane metabolism was studied to investigate if sevoflurane has an extrahepatic metabolism or possible nephrotoxicity in the presence of chronic liver disease. Plasma blood urea nitrogen (BUN) and creatinine and urine levels of N-acetyl glycosaminidase (NAG) and beta2 microglobulin were assessed intraoperatively and for 11 days postoperatively. We observed a close relation between urine NAG excretion and urine inorganic fluoride levels in the intraoperative period and early postoperative days...

A 25-year-old female underwent renal transplantation. The patient had no complication preoperatively except hypertension. Preoperative electrocardiogram revealed no abnormality. Anesthesia was maintained with sevoflurane. Donor kidney was perfused with University of Wisconsin (UW)'s solution (4 degrees C) after removal. Transient complete atrioventricular block appeared twice after reperfusion of the transplanted kidney. Adenosine in the UW's solution was considered the major cause of atrioventricular block in this patient...

The appropriate choice of anesthesia for patients (pts) undergoing renal transplantation (Ktx) requires minimal toxicity and accurate monitoring for pts at high risk for metabolic, cardiovascular, and respiratory perioperative complications. We evaluated the anesthetic management and postoperative follow-up in pediatric Ktx performed in the last 12 years in our institution. From 1988 to 1999, 75 ASA class II-III pts (45 males, 22 females) younger than 18 years scheduled for Ktx were studied: 49 received a graft from a cadaveric donor (CD) and 26 from a living donor (LD)...

We gave general anesthesia using sevoflurane to a patient undergoing cadaveric renal transplantation. Although the maximum inorganic fluoride concentration in the serum was unexpectedly high (74 uM) in the perioperative period, urine output from the transplanted kidney started simultaneously with reperfusion of the kidney and renal functions also recovered swiftly. Enzyme induction caused by anticonvulsants, which had been administered prior to operation, was assumed to be the cause of the elevation in serum inorganic fluoride concentrations in the patient...

In 32 published reports in surgical patients, the preponderance of evidence from standard clinical measures of renal function (BUN and Cr) indicates the absence of renal toxicity following sevoflurane anesthesia. Studies of surgical patients receiving intermediate-duration sevoflurane with high or low fresh gas flow and long-duration sevoflurane with high fresh gas flow included sensitive measures of renal function and/or injury, which also indicate the absence of renal toxicity following sevoflurane anesthesia...

A 29-year-old male after renal transplantation with aseptic necrosis of the head of the left femur was anesthetized with sevoflurane-nitrous oxide-oxygen for replacement surgery. Anesthesia was induced with N2O 4 l.min-1, O2 2 l.min-1, plus sevoflurane and maintained with N2O4 l.min-1, O2 2 l.min-1 and sevoflurane. Sevoflurane concentrations ranged from 1% to 4%. The serum inorganic fluoride showed the peak level of 38.4 microM.l-1 about 60 minutes after discontinuation of sevoflurane a decrease in serum inorganic fluoride was delayed...

Pharmacodynamics of vecuronium were evaluated in seven kidney transplant recipients and compared with seven patients with normal renal function. Vecuronium 0.12 mg.kg-1 was used for the initial dose and 0.03 mg.kg-1 for the second dose for each patient under general anesthesia with either isoflurane, sevoflurane or halothane plus nitrous oxide after induction by thiamylal. The effect of vecuronium was evaluated by a muscle relaxation monitor. The time to the maximum blockade (onset time) and the time of 25% recovery of the first twitch height (duration time) were measured after each administration of vecuronium in patients of both groups...