PURPOSE OF REVIEW: Organ protection remains a primary objective in the anesthetic management of patients undergoing transplantation. An ongoing effort has been made to develop strategies to improve graft outcome and reduce postoperative morbidity and mortality, but trials have reported conflicting results. The aim of this review was to provide a comprehensive summary of the anesthetic management in transplant recipients and to identify current strategies for organ protection. RECENT FINDINGS: Decreasing blood products requirements, intraoperative blood glucose control and adequate postoperative pain therapy may improve patient outcome. Vasopressors have been reported to reduce perioperative bleeding but might be associated with postoperative acute renal failure in liver transplantation. Early extubation may increase survival rates in recipients. These perioperative challenges, along with other protective strategies, have been addressed in 20 recently published studies: 10 randomized controlled trials, nine retrospective studies and one prospective study. SUMMARY: This review identified several promising strategies ensuring organ protection and improving patient outcome after solid organ transplantation. However, as outcomes were difficult to compare, further evidence will be needed before drawing firm conclusions.
PURPOSE OF REVIEW: Organ protection remains a primary objective in the anesthetic management of patients undergoing transplantation. An ongoing effort has been made to develop strategies to improve graft outcome and reduce postoperative morbidity and mortality, but trials have reported conflicting results. The aim of this review was to provide a comprehensive summary of the anesthetic management in transplant recipients and to identify current strategies for organ protection. RECENT FINDINGS: Decreasing blood products requirements, intraoperative blood glucose control and adequate postoperative pain therapy may improve patient outcome. Vasopressors have been reported to reduce perioperative bleeding but might be associated with postoperative acute renal failure in liver transplantation. Early extubation may increase survival rates in recipients. These perioperative challenges, along with other protective strategies, have been addressed in 20 recently published studies: 10 randomized controlled trials, nine retrospective studies and one prospective study. SUMMARY: This review identified several promising strategies ensuring organ protection and improving patient outcome after solid organ transplantation. However, as outcomes were difficult to compare, further evidence will be needed before drawing firm conclusions.
Authors: Giuseppe Pettinato; Sylvain Lehoux; Rajesh Ramanathan; Mohamed M Salem; Li-Xia He; Oluwatoyosi Muse; Robert Flaumenhaft; Melissa T Thompson; Emily A Rouse; Richard D Cummings; Xuejun Wen; Robert A Fisher Journal: Sci Rep Date: 2019-06-20 Impact factor: 4.379
Authors: Giuseppe Pettinato; Rajesh Ramanathan; Robert A Fisher; Martin J Mangino; Ning Zhang; Xuejun Wen Journal: Sci Rep Date: 2016-09-12 Impact factor: 4.379