Renal Transplant Flashcards
What are the most common diagnoses of patients on
the renal transplant waiting list?
The most common diagnosis for patients requiring renal transplant is type 2 diabetes. The next three most common causative diagnoses in order are hypertensive nephrosclerosis, glomerular disease, and and polycystic kidney disease.
What patient populations present contraindications
to a kidney transplant?
Those presenting with active drug abuse, complete thrombosis of the iliac veins and vena cava, active infection, and disseminated malignancies.
What is the most common cause of death following
renal transplantation?
Cardiovascular events
How does hypotension affect graft function?
Hypotension has a negative effect on graft function. It results in a decreased perfusion to the graft as well as a delay in function.
What is the greatest risk to the donor during renal
transplantation?
Hemorrhage. Blood must be available for transfusion, therefore it is imperative that adequate IV access is attained.
Why would cisatracurium be an accepted muscle
relaxant to use during a kidney transplant?
Cisatracurium is not reliant on renal function. It is eliminated in the plasma via Hofmann elimination.
Would pancuronium be an acceptible muscle
relaxant for renal transplantation?
No. Pancuronium’s primary route of excretion is through the kidneys, therefore its use is not recommended.
Where is the transplanted kidney placed?
The transplanted kidney is placed extraperitoneally in the iliac fossa.
What is the preferred anesthesia technique for a
renal transplant?
General anesthesia. Although spinal and epidural anesthesia have been used, the hypotension associated with the sympathetic blockade, along with prolonged surgery times, and heparinization of the kidney, have led to general anesthesia being the preferred approach for renal transplantation.
List a key factor in the preservation of the graft
during a kidney transplant.
The ischemic time is crucial in the preservation of the harvested organ. This ischemic time starts with the clamping of the donor’s renal vessels, and it concludes with the vascular anastomosis of the recipient.
