Nawabi Atta, Sullivan Peter, De Ruyter Martin, Pichoff Amy, King Clay D, Nawabi Perwaiz
Department of Surgery, The University of Kansas, Kansas City, KS, USA.
The Kansas City University, Kansas City, MO, USA.
J Surg Case Rep. 2020 Dec 31;2020(12):rjaa538. doi: 10.1093/jscr/rjaa538. eCollection 2020 Dec.
Kidney transplantation is the treatment of choice for patients with end-stage renal disease (ESRD). It has been shown to improve quality of life as well as extending life of patients with ESRD as compared to renal replacement therapy (5-year survival rate of 68% after transplant vs 36% dialysis) (Hart A, Smith JM, Skeans MA. OPTN/SRTR 2015 annual data report: kidney. Am J Transplant 2017;17:21-116). Traditionally, patients undergo general endotracheal tube anesthesia for this surgery. During the COVID-19 pandemic, general anesthesia drugs and airway equipment were in short supply. Additionally, airway manipulation was avoided when possible due to concern for virus spread from aerosolizing procedures (i.e. intubation/extubation). In this case report, we review a 65-year-old female with an ESRD due to hypertension and diabetes that underwent deceased donor kidney transplant under spinal anesthesia. We will further discuss the benefits of spinal anesthesia in renal transplant operations.
肾移植是终末期肾病（ESRD）患者的首选治疗方法。与肾脏替代疗法相比，肾移植已被证明可以改善ESRD患者的生活质量并延长其寿命（移植后5年生存率为68%，而透析为36%）（哈特A、史密斯JM、斯肯斯MA。OPTN/SRTR 2015年度数据报告：肾脏。《美国移植杂志》2017年；17:21-116）。传统上，患者在该手术中接受全身气管插管麻醉。在COVID-19大流行期间，全身麻醉药物和气道设备供应短缺。此外，由于担心气溶胶化操作（即插管/拔管）传播病毒，尽可能避免气道操作。在本病例报告中，我们回顾了一名65岁女性，因高血压和糖尿病患有ESRD，在脊髓麻醉下接受了尸体供肾移植。我们将进一步讨论脊髓麻醉在肾移植手术中的益处。
