Renal Transplant Flashcards
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.
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 1099-
1100.
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.
Nagelhout JJ, Plaus KL. Nurse Anesthesia. 5th ed. St. Louis,
MO: Elsevier Saunders Company; 2014: 750.
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.
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 1098.
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.
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 1098.
Where is the transplanted kidney placed?
The transplanted kidney is placed extraperitoneally in the iliac
fossa.
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 1095.
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.
Nagelhout JJ, Plaus KL. Nurse Anesthesia. 5th ed. St. Louis,
MO: Elsevier Saunders Company; 2014: 751.
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.
Nagelhout JJ, Plaus KL. Nurse Anesthesia. 5th ed. St. Louis,
MO: Elsevier Saunders Company; 2014: 750.
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.
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC,
Ortega R. Clinical Anesthesia. 7th ed. Philadelphia, PA:
Lippincott Williams and Wilkins; 2013: 1467.
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.
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 1095.
What is the most common cause of death following
renal transplantation?
Cardiovascular events
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 1099.
