当前位置： SCI文献检索 > JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA期刊下所有文献 > Anesthetic and Perioperative Considerations for Combined Heart-Kidney Transplantation.

Anesthetic and Perioperative Considerations for Combined Heart-Kidney Transplantation.

Abstract：

OBJECTIVE:To describe detailed perioperative features of combined heart and kidney transplant (HKT). DESIGN:Retrospective study. SETTING:Tertiary care university hospital. PARTICIPANTS:All consecutive HKT recipients aged 18 years and older. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:After approval of the Institutional Review Board, the authors studied all consecutive adult patients who underwent HKT between January 2013 and July 2016. Recipient and donor's demographic data, hemodynamic profile, and perioperative data were analyzed. Actuarial survival rate was 57% and 43% for in-hospital and after a mean follow-up of 135 (266) days, respectively. Among patients who required postoperative hemodialysis (n = 4), 75% (n = 3) died during hospital stay. In unadjusted analysis, patients who died had a lower postoperative cardiac index (5.4 [2.7] v 3.2 [1] L/min/m2; p = 0.034) and central venous pressure (11 [5] v 8.5 [3] mmHg; p = 0.032). All patients underwent a nonstaged surgery. When compared with preoperative hemodynamic variables, early postoperative values showed decreased systemic vascular resistance (1,333 [433] dyn/s/cm-5v 595 [176] dyn/s/cm-5; p = 0.028) and higher cardiac output (4.3 [1.4] L/min v 6.7 [3] L/min; p = 0.018). Median hospital stay was 63 (44) days. CONCLUSIONS:Anesthesiologists should be actively involved in perioperative strategies on how to manage these critical patients with severe cardiac and noncardiac comorbidities applying their expertise to HKT procedure.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Mc Loughlin S,Bianco JC,Marenchino RG

doi

10.1053/j.jvca.2017.09.018

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

44-49

issue

1

eissn

1053-0770

issn

1532-8422

pii

S1053-0770(17)30757-7

journal_volume

32

pub_type

杂志文章

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