Perioperative Care for Kidney Transplant Recipients

Hultin, Sebastian; Hawley, Carmel; Johnson, David W.; Francis, Ross

doi:10.5772/intechopen.84388

Cited by 4 publications

(3 citation statements)

References 118 publications

(104 reference statements)

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“…Trimethoprim-sulphamethoxazole is provided as prophylaxis for pneumocystis carinii pneumonia for up to 6 months and cytomegalovirus prophylaxis with valganciclovir for susceptible patients. [ 28 , 29 ]…”

Section: Recent Advances In the Perioperative Management Of Renal Tra...mentioning

confidence: 99%

Recent advances in anaesthesia for abdominal solid organ transplantation

Kumar

Sahu

Deo

et al. 2023

Indian Journal of Anaesthesia

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Organ transplantation has undergone remarkable revolution in the last two decades and offers a scope for survival amongst patients with end-stage organ failure. Along with availability of advanced surgical equipment and haemodynamic monitors, minimally invasive surgical techniques have emerged as options for surgery both amongst the donors and recipients. Newer trends in haemodynamic monitoring and expertise in ultrasound guided fascial plane blocks have changed the management in both donors and recipients. The availability of factor concentrates and point-of-care tests for coagulation have allowed optimal and restrictive fluid management of patients. Newer immunosuppressive agents are useful in minimising rejection following transplantation. Concepts on enhanced recovery after surgery have allowed early extubation, feeding and shorter hospital stay. This review gives an overview of the recent progress in anaesthesia for organ transplantation.

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Section: Recent Advances In the Perioperative Management Of Renal Tra...mentioning

confidence: 99%

Recent advances in anaesthesia for abdominal solid organ transplantation

Kumar

Sahu

Deo

et al. 2023

Indian Journal of Anaesthesia

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“…The stress related to surgery and the use of high doses of steroids during the induction period frequently induce hyperglycemia in the early post-transplant period. Insulin infusion is used perioperatively, as appropriate, to control hyperglycemia [55, 56]. In one retrospective study, the development of perioperative hyperglycemia after transplantation significantly predicted a 4-fold increase in the risk of PTDM at 1-year post-transplant [57].…”

Section: Management Of Ptdmmentioning

confidence: 99%

Post-Transplant Diabetes: Prevalence, Risk, and Management Challenges

Bashier

Kumar

Alalawi

et al. 2022

Dubai Diabetes Endocrinol J

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The prevalence of diabetes and diabetic nephropathy is increasing, especially in middle eastern countries. Many patients reach end-stage renal disease and either start dialysis or consider preemptive transplantation. Even a higher number of patients develop post-transplant diabetes, which imposes an even higher risk on graft survival and outcomes post-transplantation. Recently, in the UAE, a renal transplant service has been initiated. Because the population is considered at high risk for post-transplant diabetes, we wrote this review article to discuss the prevalence, risk factors, diagnostic criteria, and management, including lifestyle interventions, manipulation of immunosuppressant agents, and suggested algorithms for the use of oral hypoglycemic agents used in the management of post-transplantation diabetes mellitus. We also discussed the specific indications for each of the oral hypoglycemic agents.

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“…This is reflected in Canadian statistics showing a 41% increase in the total number of kidney transplants performed from 2010 and 2019. 1 Despite increased perioperative risk and higher mortality in the first 3 months posttransplantation compared with remaining on hemodialysis, 2 patient survival and quality of life after transplant are improved in the long term, as are overall costs. 3,4 Posttransplant complications affect long-term graft and patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

Evolving Medical Imaging Techniques for the Assessment of Delayed Graft Function: A Narrative Review

Hysi

Kaur

Young

2021

Can J Kidney Health Dis

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Purpose of review: Delayed graft function (DGF) is a significant complication that contributes to poorer graft function and shortened graft survival. In this review, we sought to evaluate the current and emerging role of medical imaging modalities in the assessment of DGF and how it may guide clinical management. Sources of information: PubMed, Google Scholar, and ClinicalTrial.gov up until February 2021. Methods: This narrative review first examined the pathophysiology of DGF and current clinical management. We then summarized relevant studies that utilized medical imaging to assess posttransplant renal complications, namely, DGF. We focused our attention on noninvasive, evolving imaging modalities with the greatest potential for clinical translation, including contrast-enhanced ultrasound (CEUS) and multiparametric magnetic resonance imaging (MRI). Key findings: A kidney biopsy in the setting of DGF can be used to assess the degree of ischemic renal injury and to rule out acute rejection. Biopsies are accompanied by complications and may be limited by sampling bias. Early studies on CEUS and MRI have shown their potential to distinguish between the 2 most common causes of DGF (acute tubular necrosis and acute rejection), but they have generally included only small numbers of patients and have not kept pace with more recent technical advances of these imaging modalities. There remains unharnessed potential with CEUS and MRI, and more robust clinical studies are needed to better evaluate their role in the current era. Limitations: The adaptation of emerging approaches for imaging DGF will depend on additional clinical trials to study the feasibility and diagnostic test characteristics of a given modality. This is limited by access to devices, technical competence, and the need for interdisciplinary collaborations to ensure that such studies are well designed to appropriately inform clinical decision-making.

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Perioperative Care for Kidney Transplant Recipients

Cited by 4 publications

References 118 publications

Recent advances in anaesthesia for abdominal solid organ transplantation

Recent advances in anaesthesia for abdominal solid organ transplantation

Post-Transplant Diabetes: Prevalence, Risk, and Management Challenges

Evolving Medical Imaging Techniques for the Assessment of Delayed Graft Function: A Narrative Review

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