Perioperative Assessment and Intraoperative Core Concepts in the Complex Kidney Patient

AbstractPurposeLife span and sense of well-being continue to improve post-transplantation in patients with end-stage kidney disease, despite referral of an older and more medically complex population for transplantation. In this issue of the journal, we review existing evidence about risk assessment in kidney transplant candidates from the perspective of the anesthesiologist. The authors explore cardiovascular assessment and risk in the context of intraoperative events that can influence short- and long-term outcomes.Recent FindingsThe number of patients referred for kidney transplantation continues to increase and has far exceeded the number of donor organs available. Many of these patients have become more complex with higher rates of congestive heart failure, diabetes, obesity, collagen vascular disease, and end organ dysfunction. The risk of cardiovascular disease in the end-stage renal disease patient is higher than the general population, and many studies have looked at identifying which patients are higher risk for a post-transplant cardiovascular event. Despite this, tests to detect and guide interventions are not sensitive enough to prevent early cardiovascular complications leading to graft loss and patient death. To address this issue, we explore the strengths and limitations of current cardiovascular risk evaluation paradigms and add information about physiological events during transplant surgery that can affect short- and long-term patient and graft outcomes.Sum...
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research

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Source: Clinics in Perinatology - Category: Perinatology & Neonatology Source Type: research
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
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Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
Organ transplantation is now a preferred treatment for end-stage organ failure. Among the challenges for ensuring excellent clinical outcomes for transplant recipients is good initial allograft function at the time of organ implantation. This is determined in part by the functional status of the donor and donor organ, functional status of the recipient, and conduct of the operative procedure. Despite optimization of these variables, organ transplantation is still often plagued by substantial initial dysfunction, variably referred to as slow or delayed graft function, or in the most extreme cases, primary graft nonfunction ...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
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Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
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Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
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Source: NSF Discoveries - Category: Science Source Type: research
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Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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Source: Aesthetic Plastic Surgery - Category: Cosmetic Surgery Source Type: research
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Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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