Perioperative Anesthetic Management and Clinical Outcomes in Patients Undergoing Coronary Artery Bypass Grafting and Kidney Transplant in the Same Session

Cardiovascular disease is commonly seen in patients with end-stage renal disease (ESRD) and is a major cause of graft failure and death in patients undergoing kidney transplant. The retrospective study included 77 patients with ESRD who underwent combined coronary artery bypass grafting (CABG) and k...

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Veröffentlicht in:Transplantation proceedings 2020-12, Vol.52 (10), p.3038-3043
Hauptverfasser: Atlas, Ahmet, Tekin, İlker, Yuksel, Yucel, Yavuz, Asuman, Dosemeci, Levent
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container_end_page 3043
container_issue 10
container_start_page 3038
container_title Transplantation proceedings
container_volume 52
creator Atlas, Ahmet
Tekin, İlker
Yuksel, Yucel
Yavuz, Asuman
Dosemeci, Levent
description Cardiovascular disease is commonly seen in patients with end-stage renal disease (ESRD) and is a major cause of graft failure and death in patients undergoing kidney transplant. The retrospective study included 77 patients with ESRD who underwent combined coronary artery bypass grafting (CABG) and kidney transplant between May 2010 and September 2017. The patients included 65 (84.4%) men and 12 (15.6%) women. Diabetes mellitus (DM) and hypertension (HT) were present in 71.4% and 90.9% of the patients, respectively. Mean postoperative intensive care unit (ICU) stay was 3.4 ± 1.6 days, mean time to extubation was 12.1 ± 3.7 hours, and mean hospital stay was 11.6 ± 3.5 days. In the small group with graft rejection, EF was 41.1 ± 12.3. Two patients underwent second kidney transplant, and 1 patient underwent a third kidney transplant. Mean amount of red blood cells (RBC) and fresh-frozen plasma (FFP) transfusion was 2.6 ± 0.7 and 2.1 ± 0.7 units, respectively. The study showed that CABG and kidney transplant can be performed in a combined approach in the same session and that this combined approach is likely to have a more favorable effect on mortality and morbidity compared to the administration of these 2 surgeries in separate sessions. •Kidney transplantation and CABG were performed in 77 patients in the same session in our institution.•DM and HT were present in 71.4% and 90.9% of the patients, respectively.•The donor was a spouse in 31 (40.3%), a sibling in 18 (23.4%), a daughter in 9 (11.7%), a son in 5 (6.5%), a living unrelated donor (LURD) in 5 (6.5%), a mother in 4 (5.2%), a cousin in 2 (2.6%), a father in 1 (1.3%), a sister-in-law in 1 (1.3%), and a bride in 1 (1.3%) patients.•No significant relationship was found between graft rejection and RBC and FFP transfused perioperatively.
doi_str_mv 10.1016/j.transproceed.2020.06.034
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The retrospective study included 77 patients with ESRD who underwent combined coronary artery bypass grafting (CABG) and kidney transplant between May 2010 and September 2017. The patients included 65 (84.4%) men and 12 (15.6%) women. Diabetes mellitus (DM) and hypertension (HT) were present in 71.4% and 90.9% of the patients, respectively. Mean postoperative intensive care unit (ICU) stay was 3.4 ± 1.6 days, mean time to extubation was 12.1 ± 3.7 hours, and mean hospital stay was 11.6 ± 3.5 days. In the small group with graft rejection, EF was 41.1 ± 12.3. Two patients underwent second kidney transplant, and 1 patient underwent a third kidney transplant. Mean amount of red blood cells (RBC) and fresh-frozen plasma (FFP) transfusion was 2.6 ± 0.7 and 2.1 ± 0.7 units, respectively. 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The retrospective study included 77 patients with ESRD who underwent combined coronary artery bypass grafting (CABG) and kidney transplant between May 2010 and September 2017. The patients included 65 (84.4%) men and 12 (15.6%) women. Diabetes mellitus (DM) and hypertension (HT) were present in 71.4% and 90.9% of the patients, respectively. Mean postoperative intensive care unit (ICU) stay was 3.4 ± 1.6 days, mean time to extubation was 12.1 ± 3.7 hours, and mean hospital stay was 11.6 ± 3.5 days. In the small group with graft rejection, EF was 41.1 ± 12.3. Two patients underwent second kidney transplant, and 1 patient underwent a third kidney transplant. Mean amount of red blood cells (RBC) and fresh-frozen plasma (FFP) transfusion was 2.6 ± 0.7 and 2.1 ± 0.7 units, respectively. 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The study showed that CABG and kidney transplant can be performed in a combined approach in the same session and that this combined approach is likely to have a more favorable effect on mortality and morbidity compared to the administration of these 2 surgeries in separate sessions. •Kidney transplantation and CABG were performed in 77 patients in the same session in our institution.•DM and HT were present in 71.4% and 90.9% of the patients, respectively.•The donor was a spouse in 31 (40.3%), a sibling in 18 (23.4%), a daughter in 9 (11.7%), a son in 5 (6.5%), a living unrelated donor (LURD) in 5 (6.5%), a mother in 4 (5.2%), a cousin in 2 (2.6%), a father in 1 (1.3%), a sister-in-law in 1 (1.3%), and a bride in 1 (1.3%) patients.•No significant relationship was found between graft rejection and RBC and FFP transfused perioperatively.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32758366</pmid><doi>10.1016/j.transproceed.2020.06.034</doi><tpages>6</tpages></addata></record>
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subjects Aged
Anesthesia, General - methods
Cardiovascular Diseases - complications
Cardiovascular Diseases - surgery
Coronary Artery Bypass - methods
Female
Humans
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - surgery
Kidney Transplantation - methods
Male
Middle Aged
Retrospective Studies
title Perioperative Anesthetic Management and Clinical Outcomes in Patients Undergoing Coronary Artery Bypass Grafting and Kidney Transplant in the Same Session
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