Ersoy Zeynep, Araz Coşkun, Kırnap Mahir, Zeyneloğlu Pınar, Torgay Adnan, Arslan Gülnaz
From the Department of Anesthesiology and Critical Care Medicine, Baskent University Faculty of Medicine, Ankara, Turkey.
Exp Clin Transplant. 2015 Nov;13 Suppl 3:97-100. doi: 10.6002/ect.tdtd2015.P60.
Primary hyperoxaluria type 1 is an autosomal recessive disorder that is responsible for the overproduction of oxalate and has an incidence of 1 in 120 000 live births. Indications for combined liver and kidney transplant are still debated. However, combined liver and kidney transplant is preferred in various conditions, including primary hyperoxaluria, liver-based metabolic abnormalities affecting the kidney, and structural diseases affecting both the liver and the kidney, such as congenital hepatic fibrosis and polycystic kidney disease. When compared with sequential liver and kidney transplant, the rejection rate of both liver and kidney allografts was reported to be lower than with combined liver and kidney transplant. With proper anesthesia management, the probable increased complications with combined liver and kidney transplant can be prevented. In this report, we present the anesthesia care of a 22-year-old patient with primary hyperoxaluria type 1 who had deceased-donor combined liver and kidney transplant.
1型原发性高草酸尿症是一种常染色体隐性疾病，可导致草酸盐过度生成，活产发病率为1/120000。肝肾联合移植的适应证仍存在争议。然而，在多种情况下，包括原发性高草酸尿症、影响肾脏的肝脏代谢异常以及影响肝脏和肾脏的结构性疾病，如先天性肝纤维化和多囊肾病，肝肾联合移植是首选。与序贯肝肾移植相比，据报道肝肾同种异体移植的排斥率低于肝肾联合移植。通过适当的麻醉管理，可以预防肝肾联合移植可能增加的并发症。在本报告中，我们介绍了一名22岁1型原发性高草酸尿症患者接受脑死亡供体肝肾联合移植的麻醉护理情况。
