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

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.