[Anesthesia for living donor renal transplantation in a patient with Goodpasture's syndrome with a history of repeated alveolar hemorrhage].
A 20-year-old woman was scheduled for living renal transplantation from her mother. She was diagnosed with Goodpasture's syndrome at 8 years of age and had a previous history of alveolar hemorrhage 5 times. She developed renal failure, hypertension and required hemodialysis. She had no history of surgery. Blood test was not remarkable except anemia and elevated blood urea nitrogen and serum creatinine levels. General anesthesia was induced and maintained with fentanyl, remifentanil and propofol. After tracheal intubation, the lungs were mechanically ventilated with a pressure control mode and the peak airway pressure was initially adjusted to 9 cmH2O for maintaining airway pressure at a low level to prevent alveolar injury, which was increased to 12 cmH2O at the end of surgery for maintaining a tidal volume of approximately 250 ml. No hemorrhage was detected in the airway during anesthesia, blood gas data were within the normal range, and the tracheal tube was removed after surgery in the operating room. Postoperative course was uneventful. Antihypertensive agents were discontinued and she was successfully weaned from hemodialysis.
Department ofAnesthesiology, Osaka City General Hospital and Children's Hospital, Osaka 534-0021.
Aya
A
Fukuhara
Ryu
R
Okutani
Yutaka
Y
Oda
D000768:Anesthesia, General / Q000379:methods*; D000771:Anesthesia, Intravenous / Q000379:methods*; D019867:Anti-Glomerular Basement Membrane Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008171:Lung Diseases / Q000209:etiology*; D011650:Pulmonary Alveoli; D055815:Young Adult