Erişkin canlı donör ve kadavra donör böbrek nakillerinde alıcıların intraoperatif hemodinamik parametrelerinin karşılaştırılması

Amaç: Böbrek nakli anestezisi ile ilgili çok sayıda çalışma yapılmıştır ancak verici tipine göre intraoperatif parametreler açısından literatürde yeterli veri bulunmamaktadır. Bu çalışmada canlı donör ve kadavra donör böbrek nakli (BN) yapılan erişkin hastalarda intraoperatif hemodinamik parametreleri karşılaştırmayı amaçladık.Gereç ve Yöntemler: BN yapılan hastalar verici böbrek tipine göre 2 gruba ayrıldı. Kadavra donör nakli yapılan alıcılar Grup 1 olarak çalışmaya dahil edildi. Canlı verici böbrek nakli yapılanlar arasında, Grup 1 ile benzer demografik verilere sahip aynı sayıda alıcı belirlendi ve Grup 2’ye dahil edildi. Her iki grup kaydedilen veriler ve intraoperatif hemodinamik parametreler açısından karşılaştırıldı.Bulgular: Çalışmaya 24 hasta dahil edildi. Ortalama diyaliz süreleri Grup 1 ve Grup 2 için sırasıyla 81,6 ± 64,8 ve 16,8 ± 17,4 aydı (p = 0,001). Ortalama soğuk iskemi süresi Grup 1›de Grup 2›den anlamlı olarak daha uzundu (p = 0,001). Grup 1 ve Grup 2 için operatif ortalama idrar çıkışı sırasıyla 87.3 ± 149.6 ve 634.2 ± 534.5 idi (p = 0.002). Her iki grup ortalama arter basıncı, kalp hızı, periferik oksijen satürasyonu ve CVP değerleri açısından benzerdi.Sonuç: Canlı donör nakline göre kadavra donör nakillerinde soğuk iskemi süresi daha uzundur ve operatif idrar hacmi daha düşüktür. İyi bir preoperatif hazırlık, yakın intraoperatif takip ve uygun sıvı yönetimi ile her iki tip donör alıcıda da benzer intraoperatif hemodinamik parametreler elde edilir.

Anahtar Kelimeler:

Anestezi, böbrek transplantasyonu, canlı vericiler, hemodinamik takip, kadavra

Comparison of intraoperative hemodynamic parameters of recipients in adult living donor and deceased donor kidney transplantations

Objective: There are many studies on kidney transplant anesthesia, there is not enough data in the literature in terms of intraoperative parameters according to the donor type. In this study, we aimed to compare the intraoperative hemodynamic parameters in adult patients who underwent living-donor and deceased-donor kidney transplantation (KT).Material and Methods: The patients who underwent KT were divided into 2 groups according to the donor kidney type. Recipients who underwent deceased donor transplantation were included in the study as Group 1. Among the living donor kidney transplant recipients, the same number of patients with similar demographic data as Group 1 were designated as Group 2. Both groups were compared in terms of recorded data and intraoperative hemodynamic parameters.Results: Twenty-four patients were included in the study. The mean durations of dialysis were 81.6 ± 64.8 and 16.8 ± 17.4 months for Group 1 and Group 2, respectively (p = 0.001). The mean cold ischemia time was significantly longer in Group 1 than Group 2 (p = 0.001). The mean operative urine output for Group 1 and Group 2 were 87.3 ± 149.6 and 634.2 ± 534.5, respectively (p = 0.002). Mean arterial pressure, heart rate, peripheral oxygen saturation and CVP values were all comparable between the two groups.Conclusion: Cold ischemia time is longer and operative urine volume is lower in deceased donor transplants compared to living donor transplants. With good preoperative preparation, close intraoperative follow-up, and proper fluid management, similar intraoperative hemodynamic parameters are achieved in both types of donor recipients.

Keywords:

Anesthesia, cadaver, hemodynamic monitoring, kidney transplantation, living donors,

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