Anesthesia and perioperative management for simultaneous liver-kidney-pancreas transplantation: a report of one case
- VernacularTitle:肝肾胰联合移植手术的麻醉及围术期管理
- Author:
Shaoyang CHEN
;
Huang NIE
;
Lize XIONG
- Publication Type:Journal Article
- Keywords:
liver-kidney-pancreas transplantation;
anesthesia;
perioperative management
- From:
Medical Journal of Chinese People's Liberation Army
2001;0(11):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the anesthesia and perioperative treatment for simultaneous liver-kidney-pancreas transplantation. Methods The preoperative preparation included improvement of the hepatic function, alleviation of uremia and control of blood glucose level. General anesthesia was employed and maintained with isoflurane combined with intermittent intravenous administration of midazolam, fentanyl and vecuronium. Dopamine and low dose of epinephrine were used to maintain arterial blood pressure if necessary. The parameters of blood coagulation, the indexes of hepatic and renal function, blood glucose and amylase levels in blood and urine were surveyed regularly. The treatment was adjusted according to the results of tests mentioned above. Results The circulation was stable and blood gas was normal in the course of surgery. The concentration of blood glucose was higher at the end of the operation than that of pre-operation. Normal hepatic and pancreatic function was achieved about a week after operation, while the renal function showed no satisfactory improvement. The patient was given hemodialysis until the second transplantation of kidney. Three days later, the renal function recovered to normal. Up to the present, all the grafted organs showed good function. Conclusion Appropriate preoperative preparation, optimal anesthetic procedure and management, perfect protection of function of multiple organs, and maintenance of stable hemodynamics and homeostasis were the key points of successful anesthesia and management for simultaneous liver-kidney-pancreas transplantation.
