Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.07.041
Brazilian Journal of Anesthesiology
Case Report

Approach and anesthetic management for kidney transplantation in a patient with bilateral lung transplantation: case report

Abordagem e gestão anestésica para transplante renal em doente com transplante pulmonar bilateral: relato de caso

Sofia da Silva Ramos, Ana Isabel Leite, Ana Eufrásio, Isabel Rute Vilhena, Raquel Inácio

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Abstract

Lung transplantation is the last resort for end-stage lung disease treatment. Due to increased survival, lung recipients present an increased likelihood to be submitted to anesthesia and surgery. This case report describes a 23-year-old female patient with history of lung transplantation for cystic fibrosis, with multiple complications, and chronic kidney disease, and who underwent kidney transplantation under general anesthesia. Understanding the pathophysiology and changes related to immunosuppressive therapy is essential to anesthetic technique planning and safety, and for perioperative management. The success of both anesthesia and surgery requires a qualified multidisciplinary team due to the rarity of the clinical scenario and high incidence of associated morbidity and mortality.

Keywords

General anesthesia;  Clinical case;  Cystic fibrosis;  Lung transplantation;  Kidney transplantation

Resumo

O transplante pulmonar é o último recurso no tratamento de doenças pulmonares terminais. Devido ao aumento da sobrevida, esses doentes são cada vez mais submetidos a procedimentos anestésico-cirúrgicos. Descrevemos o caso de uma doente de 23 anos com antecedentes de transplante pulmonar por fibrose cística, com múltiplas complicações, e doença renal crônica submetida a transplante renal sob anestesia geral. O conhecimento da fisiopatologia e das alterações condicionadas pela terapêutica imunossupressora são cruciais para planejamento e segurança da técnica anestésica e gestão do período peri-operatório. O sucesso anestésico-cirúrgico exige uma equipe multidisciplinar experiente pela raridade e elevada taxa de morbimortalidade associada.

Palavras-chave

Anestesia geral; Caso clínico; Fibrose cística; Transplante de pulmão; Transplante de rim

References

1 P Feltracco, G Falasco, S Barbieri, M Milevoj, E Serra, C. Ori Anesthetic considerations for nontransplant procedures in lung transplant patients J Clin Anesth, 23 (2011), pp. 508-516

2 M Seo, WJ Kim, I-C. Choi Anesthesia for non-pulmonary surgical intervention following lung transplantation – two cases report Korean J Anesthesiol, 66 (2014), pp. 322-326

3 K Hogan, D Rusy, SR. Springman Difficult laryngoscopy, and diabetes mellitus Anesth Analg, 67 (1988), pp. 1162-1165

4 S Paul, CE Escareno, K Clancy, MT Jaklitsch, R Bueno, DB. Lautz Gastrointestinal complications after lung transplantation J Heart Lung Transplant, 28 (2009), pp. 475-479

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Braz J Anesthesiol

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