title: Recent less-invasive circulatory monitoring during renal transplantation.
abstract: For anesthetic management during renal transplantation, it is necessary to maintain the blood flow and function of the transplanted kidney by performing massive fluid management and stabilizing blood pressure. We report anesthetic management for renal transplantation with a less-invasive circulatory monitoring system (Edwards Life Sciences Co., Ltd., Irvine, California, U.S.A.). In November 2010, renal transplantation was started in our hospital, and performed in 6 patients. In the first patient, fluid/circulatory management was conducted by connecting a standard arterial line and a standard central venous (CV) line. In the second patient, a FloTrac(TM) system and a standard CV line were used. In the third patient, a standard arterial line and a PreSep(TM) CV Oximetry Catheter were used. In the fourth and fifth patients, a FloTrac(TM) and a PreSep(TM) were used. In the latest patient, FloTrac(TM) and PreSep(TM) were connected to an EV1000(TM) Clinical Platform for fluid/circulatory management. The establishment of high-visibility monitors was useful for evaluating the condition and confirming the effects. As there are marked changes in hemodynamics, the CV pressure, which has been used as a parameter of fluid management, is not reliable in renal failure patients with a high incidence of cardiovascular complications. Advances in noninvasive circulatory monitoring with dynamic indices may improve the safety of anesthetic management during renal transplantation.
authors.affiliation: Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Soga
authors.forename: Shinji
authors.initials: S
authors.lastname: Kawahito
authors.forename: Rie
authors.initials: R
authors.lastname: Oi
authors.forename: Nami
authors.initials: N
authors.lastname: Kakuta
authors.forename: Toshiko
authors.initials: T
authors.lastname: Katayama
authors.forename: Narutomo
authors.initials: N
authors.lastname: Wakamatsu
authors.forename: Kazumi
authors.initials: K
authors.lastname: Takaishi
authors.forename: Kunihisa
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Izaki
authors.forename: Hiro-omi
authors.initials: HO
authors.lastname: Kanayama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kitahata
authors.forename: Shuzo
authors.initials: S
authors.lastname: Oshita
mesh_terms: D000293:Adolescent; D000328:Adult; D000758:Anesthesia / Q000379:methods*; D002302:Cardiac Output; D002496:Central Venous Pressure; D006801:Humans; D016030:Kidney Transplantation; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D010100:Oxygen / Q000097:blood
chemical_list: D010100:Oxygen