[Resuscitation during renal transplantation in children].
Over a 4 yr-period, 60 children (aged 10 months to 17 yr) received 66 kidney transplants with the same surgical intensive care program, the fist 48 hr-period of which has been analysed in this study. Thirty percent of recipients were transplanted without previous dialysis and in 8%, body weight was below 10 kg at the time of surgery. The duration of anesthesia was 4.4 +/- 1.0 h and 32% received locoregional anesthesia. The mean duration for cold ischemia was 14.7 +/- 11.7 h and 26 +/- 7 min for warm ischemia; diuresis began during the operation in 79% of the patients. Routine vascular filling consisted of standard isotonic solute (11 +/- 4 ml/kg/h) associated with mannitol infusion; 59% of recipients required 20% human serum albumin and 42% blood transfusion. Post-operative diuresis was 7.4 +/- 6.0 ml/kg/h during the first 24 h, and sometimes resulted in hypovolemic episodes; 9% of the patients had primary non-functioning kidneys (4 transient acute tubular necrosis; 2 vascular thrombosis) and 4% required dialysis; the 1-yr survival rate was 82% for the grafts and 98% of the patients.
Cochat
P
P
Unité de néphrologie et de réanimation pédiatriques, hôpital Edouard-Herriot, Lyon, France.
Long
D
D
Floret
D
D
Martin
X
X
Stamm
D
D
Faure
J L
JL
Chabrol
B
B
Maréchal
J M
JM
Palazzolo
P
P
Touraine
J L
JL
D000293:Adolescent; D000765:Anesthesia, Conduction; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007432:Intraoperative Period; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods; D007683:Kidney Tubular Necrosis, Acute / Q000209:etiology; D008297:Male; D011184:Postoperative Period; D011446:Prospective Studies; D012151:Resuscitation; D014019:Tissue Donors
Réanimation en transplantation rénale chez l'enfant.