Nicolau-Raducu Ramona, Ciancio Gaetano, Raveh Yehuda
Departmet of Anesthesiology, Solid Organ Transplant & Vascular Anesthesia, University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States.
Department of Surgery and Urology, Miami Transplant Institute/Jackson Memorial Hospital, University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States.
Front Transplant. 2024 Jun 25;3:1412391. doi: 10.3389/frtra.2024.1412391. eCollection 2024.
Kidney transplantation is the therapy of choice for end-stage kidney disease, and a fast-growing transplant procedure worldwide. Diverse clinical practices for recipients and donors' selection and management between transplant centers hinder the creation and dissemination of an anesthesia-surgical checklist.
Components of the anesthesia-surgical checklist were selected after a review of the English literature using PubMed search for donor, recipient and graft protocols and outcomes of existing practices in the field of kidney transplantation. Key elements of the most relevant articles were combined with our own center's experience and formulated into the proposed checklist. The checklist is intended to be used perioperatively, once patient receives an offer.
The perioperative checklist centers primarily on the following donor and recipient's factors: (i) Review of the pretransplant candidate workup; (ii) Assessment of donor/graft status; (iii) Hypothermic machine perfusion parameters; (iv) Operating room management; (v) Sign out. The proposed kidney transplant checklist was designed to ensure consistency and completeness of diverse tasks and facilitates team communication and coordination.
We present a novel standardized combined anesthesia-surgical checklist framework for kidney transplant aimed at increasing perioperative safety and streamline the perioperative care of recipients. Future validation studies will determine its clinical feasibility and post-implementation efficacy.
肾移植是终末期肾病的首选治疗方法，且是全球范围内快速增长的移植手术。移植中心之间在受者和供者选择及管理方面存在不同的临床实践，这阻碍了麻醉 - 手术检查表的制定与传播。
在使用PubMed检索英文文献以查找肾移植领域供者、受者及移植物方案和现有实践结果后，选取了麻醉 - 手术检查表的组成部分。将最相关文章的关键要素与我们自己中心的经验相结合，制定出拟议的检查表。该检查表旨在患者收到供肾提议后在围手术期使用。
围手术期检查表主要围绕以下供者和受者因素：（i）移植前候选者检查结果回顾；（ii）供者/移植物状态评估；（iii）低温机器灌注参数；（iv）手术室管理；（v）交接。拟议的肾移植检查表旨在确保各项不同任务的一致性和完整性，并促进团队沟通与协调。
我们提出了一种新颖的标准化肾移植联合麻醉 - 手术检查表框架，旨在提高围手术期安全性并简化受者的围手术期护理。未来的验证研究将确定其临床可行性和实施后的效果。
