[Anesthetic management of combined kidney and pancreas transplantation].
Combined kidney and pancreas transplantation was performed for the first time in Japan in a 29-year-old diabetic male with end stage renal nephropathy. He previously required injections of 44 IU insulin daily, and the fasting plasma glucose concentration before the transplant was 722 mg/dl. Anesthesia was maintained with fentanyl, nitrous oxide (70%) and halothane (0 approximately 1.0%). A continuous infusion of intravenous regular insulin (2 approximately 8 IU/hr) was started after induction of anesthesia. After revascularization of the pancreatic graft, his plasma glucose concentration fell from 350 mg/dl to 130 mg/dl in one hour and a half. Blood glucose level was maintained between 200 to 300 mg/dl without insulin during anesthesia and thereafter. The grafted kidney and pancreas showed good function during this period. In this report, anesthetic problems in combined kidney and pancreas transplantation were discussed.
Mizuyama
K
K
Takeshima
R
R
Yamaguchi
H
H
Tanaka
J
J
Kondo
Y
Y
Yamashita
M
M
Naito
H
H
D000328:Adult; D000769:Anesthesia, Inhalation; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D016035:Pancreas Transplantation