Sprung J, Kapural L, Bourke D L, O'Hara J F
Department of Anesthesiology, Cleveland Clinic Foundation, Ohio, USA.
Anesthesiol Clin North Am. 2000 Dec;18(4):919-51. doi: 10.1016/s0889-8537(05)70202-9.
Organ viability associated with renal transplantation is a product of the managing of the donor patient, the allograft, and the recipient patient. Short- and long-term outcome is influenced by perioperative fluid and drug treatment, and the function and viability of the transplanted kidney seem to be optimized if graft perfusion is maximized through mild hypervolemia. At the same time, careful balancing of intraoperative fluids is necessary against cardiovascular problems frequently encountered in patients with uremia. Close intraoperative monitoring, optimization of intravascular fluid volume status to maximize kidney perfusion, and prompt correction of electrolyte disturbances (especially potassium) are key to short- and long-term success of renal transplants.
与肾移植相关的器官存活情况是供体患者、移植肾和受体患者管理的结果。围手术期的液体和药物治疗会影响短期和长期结果,并且如果通过轻度高血容量使移植肾灌注最大化,移植肾的功能和存活情况似乎会得到优化。与此同时,必须仔细平衡术中液体量,以应对尿毒症患者常见的心血管问题。术中密切监测、优化血管内容量状态以最大化肾脏灌注以及及时纠正电解质紊乱(尤其是钾)是肾移植短期和长期成功的关键。