Perioperative Management of Kidney Transplantation in China: A National Survey in 2021

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 Feb 14

PMID 38354172

Authors

Ziyu Zhu

Xiaoying Chi

Yuwen Chen

Xiaowen Ma

Ying Tang

Dawei Li

Ming Zhang

Diansan Su

Affiliations

Soon will be listed here.

Abstract

Perioperative anaesthesia management has an important significance for kidney transplantation; however, the related consensus remains limited. An electronic survey with 44 questions was developed and sent to the chief anaesthesiologist at 115 non-military medical centres performing kidney transplantation in China through WeChat. A response rate of 81.7% was achieved from 94 of 115 non-military medical centres, where 94.4% of kidney transplants (10404 /11026) were completed in 2021. The result showed an overview of perioperative practice for kidney transplantations in China, identify the heterogeneity, and provide evidence for improving perioperative management of kidney transplantation. Some controversial therapy, such as hydroxyethyl starch, are still widely used, while some recommended methods are not widely available. More efforts on fluid management, hemodynamical monitoring, perioperative anaesthetics, and postoperative pain control are needed to improve the outcomes. Evidence-based guidelines for standardizing clinical practice are needed.

References

OMalley C, Frumento R, Hardy M, Benvenisty A, Brentjens T, Mercer J . A randomized, double-blind comparison of lactated Ringer's solution and 0.9% NaCl during renal transplantation. Anesth Analg. 2005; 100(5):1518-1524. DOI: 10.1213/01.ANE.0000150939.28904.81. View

Adwaney A, Randall D, Blunden M, Prowle J, Kirwan C . Perioperative Plasma-Lyte use reduces the incidence of renal replacement therapy and hyperkalaemia following renal transplantation when compared with 0.9% saline: a retrospective cohort study. Clin Kidney J. 2017; 10(6):838-844. PMC: 5716220. DOI: 10.1093/ckj/sfx040. View

Schmid S, Jungwirth B . Anaesthesia for renal transplant surgery: an update. Eur J Anaesthesiol. 2012; 29(12):552-8. DOI: 10.1097/EJA.0b013e32835925fc. View

Jeong R, Lentine K, Quinn R, Ravani P, Wiebe N, Davison S . NSAID prescriptions in kidney transplant recipients. Clin Transplant. 2021; 35(9):e14405. DOI: 10.1111/ctr.14405. View

Conzen P, Kharasch E, Czerner S, Artru A, Reichle F, Michalowski P . Low-flow sevoflurane compared with low-flow isoflurane anesthesia in patients with stable renal insufficiency. Anesthesiology. 2002; 97(3):578-84. DOI: 10.1097/00000542-200209000-00010. View

Tena B, Vendrell M . Perioperative considerations for kidney and pancreas-kidney transplantation. Best Pract Res Clin Anaesthesiol. 2020; 34(1):3-14. DOI: 10.1016/j.bpa.2020.01.005. View

Deman A, Peeters P, Sennesael J . Hydroxyethyl starch does not impair immediate renal function in kidney transplant recipients: a retrospective, multicentre analysis. Nephrol Dial Transplant. 1999; 14(6):1517-20. DOI: 10.1093/ndt/14.6.1517. View

Ciapetti M, di Valvasone S, Di Filippo A, Cecchi A, Bonizzoli M, Peris A . Low-dose dopamine in kidney transplantation. Transplant Proc. 2009; 41(10):4165-8. DOI: 10.1016/j.transproceed.2009.08.058. View

Myburgh J, Finfer S, Bellomo R, Billot L, Cass A, Gattas D . Hydroxyethyl starch or saline for fluid resuscitation in intensive care. N Engl J Med. 2012; 367(20):1901-11. DOI: 10.1056/NEJMoa1209759. View

10.

Perner A, Haase N, Guttormsen A, Tenhunen J, Klemenzson G, Aneman A . Hydroxyethyl starch 130/0.42 versus Ringer's acetate in severe sepsis. N Engl J Med. 2012; 367(2):124-34. DOI: 10.1056/NEJMoa1204242. View

11.

Abbasi M, Chertow G, Hall Y . End-stage Renal Disease. Am Fam Physician. 2010; 82(12):1512. View

12.

Wu Y, Wu A, Wang J, Tian M, Jia X, Rui Y . Effects of the novel 6% hydroxyethyl starch 130/0.4 on renal function of recipients in living-related kidney transplantation. Chin Med J (Engl). 2010; 123(21):3079-83. View

13.

Lauschke A, Teichgraber U, Frei U, Eckardt K . 'Low-dose' dopamine worsens renal perfusion in patients with acute renal failure. Kidney Int. 2006; 69(9):1669-74. DOI: 10.1038/sj.ki.5000310. View

14.

Chadban S, Ahn C, Axelrod D, Foster B, Kasiske B, Kher V . KDIGO Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation. Transplantation. 2020; 104(4S1 Suppl 1):S11-S103. DOI: 10.1097/TP.0000000000003136. View

15.

Wagener G, Bezinover D, Wang C, Kroepfl E, Diaz G, Giordano C . Fluid Management During Kidney Transplantation: A Consensus Statement of the Committee on Transplant Anesthesia of the American Society of Anesthesiologists. Transplantation. 2020; 105(8):1677-1684. DOI: 10.1097/TP.0000000000003581. View

16.

Faba O, Boissier R, Budde K, Figueiredo A, Taylor C, Hevia V . European Association of Urology Guidelines on Renal Transplantation: Update 2018. Eur Urol Focus. 2018; 4(2):208-215. DOI: 10.1016/j.euf.2018.07.014. View

17.

Morkane C, Fabes J, Banga N, Berry P, Kirwan C . Perioperative management of adult cadaveric and live donor renal transplantation in the UK: a survey of national practice. Clin Kidney J. 2019; 12(6):880-887. PMC: 6885684. DOI: 10.1093/ckj/sfz017. View

18.

Chiasson J, Fominaya C, Gebregziabher M, Taber D . Long-term Assessment of NSAID Prescriptions and Potential Nephrotoxicity Risk in Adult Kidney Transplant Recipients. Transplantation. 2019; 103(12):2675-2681. PMC: 6717690. DOI: 10.1097/TP.0000000000002689. View

19.

Calixto Fernandes M, Schricker T, Magder S, Hatzakorzian R . Perioperative fluid management in kidney transplantation: a black box. Crit Care. 2018; 22(1):14. PMC: 5784708. DOI: 10.1186/s13054-017-1928-2. View

20.

Othman M, Ismael A, Hammouda G . The impact of timing of maximal crystalloid hydration on early graft function during kidney transplantation. Anesth Analg. 2010; 110(5):1440-6. DOI: 10.1213/ANE.0b013e3181d82ca8. View