I Renal transplant
Renal transplantation has been performed for nearly a century and is an accepted means of replacing kidney function in patients with end-stage renal disease who are on maintenance dialysis. In this procedure, the donor kidney is placed extraperitoneally in the recipient’s iliac fossa. The renal artery is anastomosed to the internal iliac artery, the renal vein to either the external or the common iliac vein and the ureter to the bladder. The anesthesia provider plays a vital role in management of the viability of the transplanted kidney. Three interrelated variables affect surgical outcomes: management of the donor, preservation of the harvested organ, and perioperative care of the transplant recipient. Additionally, improved surgical and immunosuppressive techniques have contributed to better outcomes in terms of graft survival.
Warm | Cold | |
Begins | Clamping of donor vessels; initial placement in recipient | Perfusion of harvested organ with cold preservation solution; storage at 4° C |
Ends | Vascular anastomosis in recipient; interrupted with perfusion of cold preservation solution | Perfusion by recipient |
Anesthesia for Renal Transplant