Anesthesia for Renal Transplantation

280 Pages·1987·6.275 MB·English

by  Gwendolyn B. Graybar (auth.), Gwendolyn B. Graybar M.D., Lois L. Bready M.D. (eds.)

ANESTHESIA FOR RENAL TRANSPLANTATION
DEVELOPMENTS IN CRITICAL CARE MEDICINE AND
ANESTHESIOLOGY
Prakash, O. (ed.): Applied Physiology in Clinical Respiratory Care. 1982.
ISBN 90-247-2662-X.
McGeown, Mary G.: Clinical Management of Electrolyte Disorders. 1983.
ISBN 0-89838-559-8.
Scheck, P.A., Sjostrand, U.H., and Smith, R.B. (eds.): Perspectives in High
Frequency Ventilation. 1983. ISBN 0-89838-571-7.
Stanley, T.H., and Petty, w.e. (eds.): New Anesthetic Agents, Devices and
Monitoring Techniques. 1983. ISBN 0-89838-566-0.
Prakash, O. (ed.): Computing in Anesthesia and Intensive Care. 1983.
ISBN 0-89838-602-0.
Stanley, T.H., and Petty, W.e. (eds.): Anesthesia and the Cardiovascular Sys
tem. 1984. ISBN 0-89838-626-8.
Van Kleef,].W., Burm, A.G.1., and Spierdijk,]. (eds.): Current Concepts in
Regional Anaesthesia. 1984. ISBN 0-89838-644-6.
Prakash, o. (ed.): Critical Care of the Child. 1984. ISBN 0-89838-661-6.
Stanley, T.H., and Petty, w.e. (eds.): Anesthesiology: Today and Tomor
row. 1985. ISBN 0-89838-705-1.
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ture. 1985. ISBN 0-89838-708-6.
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ISBN 0-89838-779-5.
de Lange, S., Hennis, P.]., and Kettler, D. (eds.): Cardiac Anaesthesia: Prob
lems and Innovations. 1986. ISBN 0-89838-794-9.
de Bruijn, N.P., and Clements, F.M.: Transesophageal Echocardiography.
1987. ISBN 0-89838-821-X.
Graybar, G.B., and Bready, 1.1. (eds.): Anesthesia for Renal Transplantation.
1987. ISBN-13: 978-1-4612-9211-1.
Stanley, T.H., and Petty, W.E. (eds.): Anesthesia, the Heart, and the Vascular
System. 1987. ISBN 0-89838-851-1.
ANESTHESIA FOR RENAL TRANSPLANTATION
EDITED BY
GWENDOLYN B GRA YBAR, M.D.
The University of Alabama at Birmingham
AND
LOISLBREADY, M.D.
The University of Texas, San Antonio
Martinus Nijhoff Publishing
a member of the Kluwer Academic Publishers Group
Boston I Dordrecht I Lancaster
Distributors
for the United States and Canada: Kluwer Academic Publishers, 101 Philip Drive, Assinippi Park,
Norwell, MA, 02061, USA
for the UK and Ireland: Kluwer Academic Publishers, MTP Press Limited, Falcon House,
Queen Square, Lancaster LAI lRN, UK
for all other countries: Kluwer Academic Publishers Group, Distribution Centre, P. O. Box 322,
3300 AH Dordrecht, The Netherlands
Library of Congress Cataloging-in-Publication Data
Anesthesia for renal transplantation.
(Developments in critical care medicine and anesthesiology)
1. Kidneys-Transplantation. 2. Anesthesia. 3. Critical care medicine. I. Graybar,
Gwendolyn B II. Bready, Lois L III. Series: Developments in critical care medicine and
anesthesiology. [DNLM: 1. Anesthesia. 2. Kidney-transplantation. W] 368 A579)
RD575.A541986 617'.967461 86-23567
ISBN-13: 978-1-4612-9211-1 e-ISBN-13: 978-1-4613-2035-7
DOl: 10.1007/978-1-4613-2035-7
Copyright
© 1987 by Martinus NijhoffPublishing, Boston
Softcover reprint of the hardcover I st edition 1987
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted in any form or by any means, mechanical, photocopying, recording, or otherwise,
without the prior written permission of the publisher, Martinus NijoffPublishing, 101 Philip
Drive, Assinippi Park, Norwell, MA 02061, USA
To our husbands, Andy Graybar and Joe Holahan
CONTENTS
Contributing authors ix
Foreword by LEROY D VANDAM Xll
Preface xiv
1. History of renal transplantation
GWENDOLYN B GRAYBAR
2. Renal anatomy and pathophysiology 23
MARGARET TARPEY
3. The medical management of renal transplant patients 31
JOHN J CURTIS
4. Brain death and management of the cadaveric donor 47
PAMELA D VARNER AND ROBERT D MCKAY
5. The living related donor 69
LOIS L BREADY
6. Surgical aspects of renal transplantation 83
JOHN D WHELCHEL
7. Monitoring 99
LOIS L BREADY
8. Fluids, electrolytes, and blood transfusions 107
JAMES R BOYCE
viii Contents
9. Intravenous agents and renal failure 123
JOHN A YOUNGBERG
10. Choice of anesthesia 139
GWENDOLYN B GRAYBAR
11. Muscle relaxants and renal failure 157
GWENDOLYN B GRAYBAR
12. Postanesthetic recovery 177
LOIS L BREADY
13. Anesthesia-related morbidity 191
LOIS L BREADY
14. Anesthesia for pediatric renal transplantation 199
ELENA ADLER AND PATRICIA A GIBBONS
15. Anesthesia for vascular access and other procedures 213
GWENDOLYN B GRAYBAR AND HAMDI ERDEMIR
16. A game plan 247
GWENDOLYN B GRAYBAR AND LOIS L BREADY
Index 265
CONTRIBUTING AUTHORS
Elena Adler, M.D.
Assistant Professor of Anesthesiology and
Pediatrics
University of Cincinnati College of Medicine
Elland at Bethesda Avenue
Cincinnati, Ohio 45229
James R Boyce, M.D.
Associate Professor of Anesthesiology
The University of Alabama at Birmingham
University Station
Birmingham, Alabama 35294
Lois L Bready, M.D.
Associate Professor of Anesthesiology
The University of Texas
Health Science Center at San Antonio
7703 Floyd Curl Drive
San Antonio, Texas 78284-7838
JohnJ Curtis, M.D.
Professor of Medicine
The University of Alabama at Birmingham
Nephrology Research and Training Center
University Station
Birmingham, Alabama 35294
Hamdi Erdemir, M.D.
Professor of Anesthesiology
Chief of Special Services
The University of Alabama at Birmingham
University Station
Birmingham, Alabama 35294
x Contributing authors
Patricia A Gibbons, M.D.
Assistant Professor of Anesthesiology
University of Cincinnati College of Medicine
Children's Hospital Medical Center
Eiland at Bethesda Avenue
Cincinnati, Ohio 45229
Gwendolyn B Graybar, M.D.
Professor of Anesthesiology
The University of Alabama at Birmingham
University Station
Birmingham, Alabama 35294
Robert D McKay, M.D.
Associate Professor of Anesthesiology
The University of Alabama at Birmingham
University Station
Birmingham, Alabama 35294
Margaret Tarpey, M.D.
Instructor of Anesthesiology
The University of Alabama at Birmingham
University Station
Birmingham, Alabama 35294
Leroy D Vandam, M.D.
Professor of Anaesthesia, Emeritus
Harvard Medical School
Anesthesiologist, Brigham and Women's
Hospital
75 Francis Street
Boston, Massachusetts 02115
Pamela D Varner, M.D.
Assistant Professor of Anesthesiology
The University of Alabama at Birmingham
University Station
Birmingham, Alabama 35294
John D Whelchel, M.D.
Livingston Professor of Surgery
Emory University School of Medicine
1634 Clifton Road, NE
Atlanta, Georgia 30322
John A Youngberg, M.D.
Associate Professor of Anesthesiology
Director of Research
Tulane University School of Medicine
1430 Tulane Avenue
New Orleans, Louisiana 70112
"TO REMEMBER ME ..."
The day will come when my body will lie upon a white sheet neatly tucked under four
corners of a mattress located in a hospital busily occupied with the living and the dying.
At a certain moment a doctor will determine that my brain has ceased to function and
that, for all intents and purposes, my life has stopped.
When that happens, do not attempt to instill artificial life into my body by the use of
a machine. And don't call this my deathbed. Let it be called the Bed of Life, and let my
body be taken from it to help others lead fuller lives.
Give my sight to the man who has never seen a sunrise, a baby's face or love in the
eyes of a woman. Give my heart to a person whose own heart has caused nothing but
endless days of pain. Give my blood to the teenager who was pulled from the wreckage
of his car, so that he might live to see his grandchildren play. Give my kidneys to one
who depends on a machine to exist from week to week. Take my bones, every muscle,
every fiber and nerve in my body and find a way to make a crippled child walk.
Explore every corner of my brain. Take my cells, if necessary, and let them grow so
that, someday, a speechless boy will shout at the crack of a bat and a deaf girl will hear
the sound of rain against her window.
Burn what is left of me and scatter the ashes to the winds to help the flowers grow.
If you must bury something, let it be my faults, my weaknesses and all prejudice
against my fellow man.
Give my sins to the devil. Give my soul to God.
If, by chance, you wish to remember me, do it with a kind deed or word to someone
who needs you. If you do all I have asked, I will live forever.
Robert N Test in Cincinnati Post
xi