Factors to consider during anesthesia in patients undergoing preemptive kidney transplantation: a propensity-score matched analysis
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Kim, Jeayoun | - |
dc.contributor.author | Lee, Kyo Won | - |
dc.contributor.author | Kim, Keoungah | - |
dc.contributor.author | Kang, Hyeryung | - |
dc.contributor.author | Yang, Jaehun | - |
dc.contributor.author | Park, Jae Berm | - |
dc.contributor.author | Kim, Gaabsoo | - |
dc.date.accessioned | 2023-08-25T08:40:58Z | - |
dc.date.available | 2023-08-25T08:40:58Z | - |
dc.date.created | 2023-08-25 | - |
dc.date.issued | 2023-08 | - |
dc.identifier.issn | 1471-2253 | - |
dc.identifier.uri | https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/88845 | - |
dc.description.abstract | BackgroundInternational guidelines have recommended preemptive kidney transplantation (KT) as the preferred approach, advocating for transplantation before the initiation of dialysis. This approach is advantageous for graft and patient survival by avoiding dialysis-related complications. However, recipients of preemptive KT may undergo anesthesia without the opportunity to optimize volume status or correct metabolic disturbances associated with end-stage renal disease. In these regard, we aimed to investigate the anesthetic events that occur more frequently during preemptive KT compared to nonpreemptive KT.MethodsThis is a single-center retrospective study. Of the 672 patients who underwent Living donor KT (LDKT), 388 of 519 who underwent nonpreemptive KT were matched with 153 of 153 who underwent preemptive KT using propensity score based on preoperative covariates. The primary outcome was intraoperative hypotension defined as area under the threshold (AUT), with a threshold set at a mean arterial blood pressure below 70 mmHg. The secondary outcomes were intraoperative metabolic acidosis estimated by base excess and serum bicarbonate, electrolyte imbalance, the use of inotropes or vasopressors, intraoperative transfusion, immediate graft function evaluated by the nadir creatinine, and re-operation due to bleeding.ResultsAfter propensity score matching, we analyzed 388 and 153 patients in non-preemptive and preemptive groups. The multivariable analysis revealed the AUT of the preemptive group to be significantly greater than that of the nonpreemptive group (mean & PLUSMN; standard deviation, 29.7 & PLUSMN; 61.5 and 14.5 & PLUSMN; 37.7, respectively, P = 0.007). Metabolic acidosis was more severe in the preemptive group compared to the nonpreemptive group. The differences in the nadir creatinine value and times to nadir creatinine were statistically significant, but clinically insignificant.ConclusionIntraoperative hypotension and metabolic acidosis occurred more frequently in the preemptive group during LDKT. These findings highlight the need for anesthesiologists to be prepared and vigilant in managing these events during surgery. | - |
dc.language | 영어 | - |
dc.language.iso | en | - |
dc.publisher | BMC | - |
dc.relation.isPartOf | BMC ANESTHESIOLOGY | - |
dc.title | Factors to consider during anesthesia in patients undergoing preemptive kidney transplantation: a propensity-score matched analysis | - |
dc.type | Article | - |
dc.type.rims | ART | - |
dc.description.journalClass | 1 | - |
dc.identifier.wosid | 001041341200001 | - |
dc.identifier.doi | 10.1186/s12871-023-02208-8 | - |
dc.identifier.bibliographicCitation | BMC ANESTHESIOLOGY, v.23, no.1 | - |
dc.description.isOpenAccess | Y | - |
dc.identifier.scopusid | 2-s2.0-85166597550 | - |
dc.citation.title | BMC ANESTHESIOLOGY | - |
dc.citation.volume | 23 | - |
dc.citation.number | 1 | - |
dc.contributor.affiliatedAuthor | Yang, Jaehun | - |
dc.type.docType | Article | - |
dc.subject.keywordAuthor | End-stage renal disease | - |
dc.subject.keywordAuthor | Intraoperative hypotension | - |
dc.subject.keywordAuthor | Living donor kidney transplantation | - |
dc.subject.keywordAuthor | Metabolic acidosis | - |
dc.subject.keywordAuthor | Preemptive kidney transplantation | - |
dc.subject.keywordPlus | VENTRICULAR DIASTOLIC FUNCTION | - |
dc.subject.keywordPlus | SEVERE LACTIC-ACIDOSIS | - |
dc.subject.keywordPlus | STAGE RENAL-DISEASE | - |
dc.subject.keywordPlus | INTRAOPERATIVE HYPOTENSION | - |
dc.subject.keywordPlus | EUROPEAN ASSOCIATION | - |
dc.subject.keywordPlus | AMERICAN SOCIETY | - |
dc.subject.keywordPlus | RECOMMENDATIONS | - |
dc.subject.keywordPlus | OUTCOMES | - |
dc.subject.keywordPlus | ECHOCARDIOGRAPHY | - |
dc.subject.keywordPlus | DURATION | - |
dc.relation.journalResearchArea | Anesthesiology | - |
dc.relation.journalWebOfScienceCategory | Anesthesiology | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.
1342, Seongnam-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do, Republic of Korea(13120)031-750-5114
COPYRIGHT 2020 Gachon University All Rights Reserved.
Certain data included herein are derived from the © Web of Science of Clarivate Analytics. All rights reserved.
You may not copy or re-distribute this material in whole or in part without the prior written consent of Clarivate Analytics.