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200 hastada renal transplantasyon anestezisi deneyimlerimiz: Bir retrospektif çalışma

Anaesthetic experience of 200 renal transplantation cases: A retrospective study

Journal Name:

  • Abant Tıp Dergisi

Publication Year:

  • 2016
DOI: 
10.5505/abantmedj.2016.08831

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
INTRODUCTION: Renal transplantation is the best method of treatment for end-stage renal disease. Anaesthetic management should be well-planned during preoperative, intraoperative and postoperative period. Several studies have done for renal transplantation anaesthesia. Some studies have investigated the anaesthesia technique, some of them investigated effect of anaesthetic drugs on patients and transplanted kidneys etc. In this study, we aimed to compare our results with literature and to present our experience of anaesthetic management in 200 renal transplantation patients. METHODS: We used the patients’ files for obtaining the data. RESULTS: We used intravenous anaesthetics which were propofol (2 mg/kg), fentanyl (2-3 μgr/kg) and atracurium (0.6 mg/kg) or rocuronium (0.6 mg/kg) were used as muscle relaxants for the induction. During anaesthesia, 1-2% isoflurane (n: 67), 1-2% sevoflurane (n: 49) or 6-7% desflurane (n: 79) was used for maintenance of the anaesthesia.Remifentanil infusion (0.25-0.5 μgr/kg/min) was used for intraoperative analgesia. The average duration of the surgery was 3.18 hrs (±0.64SD) and anaesthesia was 3,7 hrs (±0.65SD). There were 135 (67,5%) male, 65 (32,5%) female patients and type of the transplantation was 123 living-related (61.5%) and 77 cadaveric (38.5%). End stage renal disease (ESRD) reasons were hypertension (27.5%, n: 55), diabetes mellitus ( 22.5%, n: 45), unknown (18.5%, n: 37), chronic glomerulonephritis (13.5%, n: 27), amyloidosis (8.5%, n: 17) and others (9.5%, n: 19) in this study.Acute rejection was seen in 21 (10.5%) cases and the delayed graft function was seen in 27 (13.5%) cases. 24 (12%) patients died during post-transplantation period. DISCUSSION AND CONCLUSION: Renal transplantation is a good choice for chronic renal failure and anaesthetic management is so important for graft function. Our anaesthetic management and results are similar to the literature.
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Abstract (Original Language): 
GİRİŞ ve AMAÇ: Böbrek nakli son dönem böbrek yetmezliği tedavisinde en iyi tedavi şeklidir. Anestezi yönetimi preoperatif, postoperatif ve intraoperatif dönem boyunca iyi planlanmalıdır. Böbrek nakli ile ilgili olarak birçok çalışma yapılmıştır. Bunlardan bazıları anestezi tekniklerini incelemiş olup bazıları anestezik ilaçların hasta ve nakil edilen böbrek üzerine etkilerini incelemişlerdir. Biz bu çalışmada böbrek nakli gerçekleştirilen 200 hastanın anestezi yönetimleriyle ilgili deneyimlerimizi sunmayı amaçladık. YÖNTEM ve GEREÇLER: Verileri elde etmek için hasta dosyaları kullanıldı. BULGULAR: Anestezi indüksiyonunda intravenöz ajanlardan propofol (2 mg/kg), fentanil (2-3 μgr/kg) ve kas gevşetici olarak roküronyum (0.6 mg/kg) veya atraküryum (0.6 mg/kg) kullanıldı. Operasyonda anestezi idamesi için % 1-2 izofluran (n: 67), % 1-2 sevofluran (n: 49), % 6-7 desfluran kullanıldı. İntraoperativ analjezik olarak remifentanil (0.25-0.5 μgr/kg/min) kullanıldı. Ortalama cerrahi süre 3.18 (±0.64 SS) saat, ortalama anestezi süresi 3,7 (±0.65 SS) saat olarak tespit edildi. Hastaların 135’i (67,5%) erkek 65’i (32,5%) kadındı ve 123 (61.5%) hastada canlıdan canlıya transplantasyon yapılırken 77 (38.5%) hastaya kadavradan yapılmıştır. Bu çalışmada hipertansiyon (27.5%, n: 55), diabetes mellitus ( 22.5%, n: 45), sebebi bilinmeyen (18.5%, n: 37), kronik glomerulonefrit (13.5%, n: 27), amiloidoz (8.5%, n: 17) and diğerleri (9.5%, n: 19) son dönem böbrek yetmezliği nedenleriydi. Akut rejeksiyon 21 (10.5%) hastada görülürken gecikmiş greft fonksiyonu 27 (13.5%) hastada görüldü. 24 (12%) hastada transplantasyon sonrası takiplerinde mortalite tespit edildi. TARTIŞMA ve SONUÇ: Renal transplantasyon böbrek yetmezliği tedavisi için iyi bir seçimdir ve anestezi yönetimi greft fonksiyonu için çok önemlidir. Bizim çalışmamızdaki anestezi yönetimi ve sonuçlarımız literatürle benzerdi.
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