Anesthetic Experience of 1000 Cases During 10 Years in Renal Transplantation: A Retrospective Study

Background: Since the first renal transplantation surgery, clinical studies have failed to ascertain the benefit of one anesthetic technique over another. Objectives: This article provides an overview of the important issues to be considered in these patients, and also discusses several anesthetic challenges in these surgeries. Patients and Methods: Through a retrospective study, we described our experience during 10 years, from 2002 until 2012, in 1000 cases of living and cadaveric transplants. We reviewed their medical history and noted age, sex, blood groups, cause of end stage renal disease, history of dialysis and the type of renal transplantation. Preoperative investigation and preparation, as well as details of anesthetic management, were also recorded. Results: General anesthesia was performed in 82% of patients and for the rest of them, spinal, epidural and combined spinal and epidural were done. The age of the patients was in the range of 12 - 68 years, with the mean of 36 ± 11 years. The mean of surgery duration was 2.9 ± 1.1 hours. The most significant point during surgery is keeping the mean arterial pressure 95 mmHg and maintaining fluid load with crystalloid. Conclusions: The type and amount of fluid replacement therapy and optimizing hemodynamic status, before and during reperfusion of the transplanted kidney, are of particular importance during renal transplantation surgery.