The New Kidney Donor Allocation System and Implications for Anesthesiologists
| Autor: | Angelina Edwards, Mark J. Hobeika, Semhar J. Ghebremichael, Sara Guzman-Reyes, Srikanth Sridhar, Sam D. Gumbert, Wasim A. Dar, Evan G. Pivalizza |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Tissue and Organ Procurement medicine.medical_treatment 030232 urology & nephrology Disease 030230 surgery 03 medical and health sciences 0302 clinical medicine Anesthesiology medicine Humans Anesthesia Intensive care medicine Dialysis Organ system Cardiopulmonary disease Kidney Perioperative management business.industry Kidney Transplantation Tissue Donors Anesthesiologists Transplantation Anesthesiology and Pain Medicine medicine.anatomical_structure Cardiology and Cardiovascular Medicine business |
| Zdroj: | Seminars in Cardiothoracic and Vascular Anesthesia. 22:223-228 |
| ISSN: | 1940-5596 1089-2532 |
| Popis: | Given potential disparity and limited allocation of deceased donor kidneys for transplantation, a new federal kidney allocation system was implemented in 2014. Donor organ function and estimated recipient survival in this system has implications for perioperative management of kidney transplant recipients. Early analysis suggests that many of the anticipated goals are being attained. For anesthesiologists, implications of increased dialysis duration and burdens of end-stage renal disease include increased cardiopulmonary disease, challenging fluid, hemodynamic management, and central vein access. With no recent evidence to guide anesthesia care within this new system, we describe the kidney allocation system, summarize initial data, and briefly review organ systems of interest to anesthesiologists. As additional invasive and echocardiographic monitoring may be indicated, one consideration may be development of a dedicated anesthesiology team experienced in management and monitoring of complex patients, in a similar manner as has been done for liver transplant recipients. |
| Databáze: | OpenAIRE |
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