Preoperative ultrasonographic findings of internal jugular veins and carotid arteries in kidney transplant recipients.
10.4097/kjae.2016.69.4.375
- Author:
Ji Won CHOI
1
;
Gaab Soo KIM
;
Seung Won LEE
;
Jeong Bo PARK
;
Jeong Jin LEE
;
Justin Sangwook KO
Author Information
1. Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. gskim@skku.edu
- Publication Type:Original Article
- Keywords:
Central venous catheterization;
Kidney transplantation;
Safety;
Ultrasonography
- MeSH:
Adult;
Carotid Arteries*;
Catheterization;
Catheterization, Central Venous;
Catheters;
Constriction, Pathologic;
Dialysis;
Humans;
Jugular Veins*;
Kidney Failure, Chronic;
Kidney Transplantation;
Kidney*;
Multivariate Analysis;
Odds Ratio;
Renal Dialysis;
Transplant Recipients*;
Ultrasonography
- From:Korean Journal of Anesthesiology
2016;69(4):375-381
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Hemodialysis via the internal jugular vein (IJV) has been widely used for patients with end stage renal disease (ESRD) patients, as they have a higher risk of arterial diseases. We investigated the ultrasonographic findings of the IJV and carotid artery (CA) in recipients of kidney transplantation (KT) and identified factors influencing IJV/CA abnormalities. METHODS: We enrolled 120 adult KT recipients. Patients in group A (n = 57) had a history of IJV hemodialysis, while those in group B (n = 63) were not yet on dialysis or undergoing dialysis methods not involving the IJV. The day before surgery, we evaluated the state of the IJV and CA using ultrasonography. We followed patients with IJV stenosis for six months after KT. RESULTS: Ultrasonography revealed that four patients (7%) in group A had IJV abnormalities, while no patients in group B had abnormalities (P = 0.118). Of the four patients with abnormalities, one with 57.4% stenosis normalized during follow- up. However, another patient with 90.1% stenosis progressed to occlusion, while the two patients with total occlusion remained the same. Twenty patients in group A (n = 11) and B (n = 9) had several CA abnormalities (P = 0.462). Upon multivariate analysis with stepwise selection, height and age were significantly correlated with IJV stenosis (P = 0.043, odds ratio = 0.9) and CA abnormality (P = 0.012, odds ratio = 1.1), respectively. CONCLUSIONS: IJV abnormalities (especially with a history of IJV hemodialysis) and CA abnormalities may be present in ESRD patients. Therefore, we recommend ultrasonographic evaluation before catheterization.
