Anestesia Analgesia Reanimación
versión impresa ISSN 0255-8122
SUMMARY Renopancreatic transplantation is the elective treatment for chronic kidney faillure. 35 renopancreatic transplantation were performed from june 2002 to may 2010 in the University Hospital. The patients had diabetes in advanced stages. They were in dialisis for large periods, with a high incidence of associate medical pathology. General anesthesia was performed in all patients. Arterial and central venous lines were added to standard monitorization. Serial laboratory studies were done in all cases. Continuous infusión of insulina was administrated to controlled the glycemia. The average duration of the procedure was 407,9 ± 76,4 min. The intraoperatively replacement was made based on crystalloid and colloid (4.665 ± 2.127 ml and 1.015 ± 492 ml respectively). Twenty-one patients (60%) were given red package cells (85 502 ml). The average balance was positive: 1.430 ± 832 ml. We used titrated doses of vasoactive drugs in addition to volume, to maintain stable hemodynamics. Eight patients (22,8%) had transient hypotension, 14 patients (40%) had metabolic acidosis; 8 patients (22,8%) had mild hypokalemia and 3 (8,5%) hypoglycemia. Twenty-three patients (65%) required at least one reoperation in the initial hospitalization. Overall mortality was 11,4% (4 patients), 2,8% (one of them) occured in the first 48 hours. Eight patients (22,8%) had renal failure from the start of postoperative period. Fifteen pancreas (42,8%) were lost, 5 of them (14,2%) within 48 hours. Thirty-one patients are alive (88%); 25 preserved the renal function (80.6%) and 20 the pancreatic function (64,5%). It shows a high incidence of early surgical anesthetic complications. Those complications are important on the short-and long-term
Palabras llave : kidney-pancreas transplantation; perioperative hemodynamics; anesthesia complications .