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Intraoperative Management of the Kidney Transplant Recipient

  • Kidney Transplantation (M Henry, Section Editor)
  • Published:
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Abstract

Purpose of Review

The purpose of this study was to review current literature on the intraoperative management of the kidney transplant recipient in terms of preoperative evaluation, anesthetic agents of choice, monitoring needs, intraoperative fluid and hemodynamic management, and perioperative pain control options.

Recent Findings

More recent literature regarding intraoperative kidney management suggests less aggressive volume loading with a balanced crystalloid solution, particularly in regard to albumin and blood products, with increased consideration for multimodal therapies for nausea and pain control.

Summary

Perioperative kidney management is crucial to immediate- and long-term outcomes for graft and patient survival. Surgical and anesthetic techniques should continue to be honed to allow for ideal renal perfusion intraoperatively. Considerations for intraoperative optimization for renal transplantation include the appropriate types and volume of fluid based on cardiac risk factors with the increasing number of elderly recipients, the avoidance of vasoconstrictive agents, and a reduction in perioperative cardiac-depressing agents for pain that may be managed by multimodal therapies.

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Author information

Authors and Affiliations

  1. Division of Kidney and Pancreas Transplantation, Department of General Surgery, Vanderbilt University Medical Center, 1313 21st Avenue South, Oxford House, Suite 912, Nashville, TN, 37232, USA

    Rachel C. Forbes

  2. Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    Beatrice P. Concepcion

  3. Division of Critical Care Medicine, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA

    Adam B. King

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  1. Rachel C. Forbes
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  2. Beatrice P. Concepcion
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  3. Adam B. King
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Correspondence to Rachel C. Forbes.

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Rachel Forbes, Adam King, and Beatrice Concepcion declare no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Kidney Transplantation

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Forbes, R.C., Concepcion, B.P. & King, A.B. Intraoperative Management of the Kidney Transplant Recipient. Curr Transpl Rep 4, 75–81 (2017). https://doi.org/10.1007/s40472-017-0142-0

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