bachelorThesis
Manejo anestésico de pacientes llevados a trasplante combinado hígado–riñón en la Fundación Cardioinfantil, entre el 1o de enero del 2005 al 31 de diciembre del 2021
Autor
Santamaría Rodríguez, Paula
Institución
Resumen
Simultaneous liver-kidney transplantation (TSHR) is a complex, infrequent procedure that is the treatment of choice in patients with concurrent end-stage liver and kidney failure [1]. This study is descriptive and observational, and its objective is to analyze the experience with TSHR at Fundación Cardioinfantil from January 1, 2005, to December 31, 2021. Regarding the methodology, after institutional approval, a retrospective review was carried out. of TSHR cases eliminated between 2005 and 2021, collecting pre, intra, and postoperative parameters. It was found that during the study period, 31 TSHR were performed, corresponding to 4.1% of liver transplants and 5.9% of kidney transplants; the number of procedures remained stable over time. Of the total cases, 8 were pediatric. The median of the MELD (Model for End-stage Liver Disease) was 20.5 points (IQR 14-22.8). The most common liver etiology in adults was alcoholic cirrhosis (52.1%) and in the child population congenital liver fibrosis (62.5%). The most common kidney disease in adults was diabetic nephropathy (52.1%), while nephronopthisis prevailed in children (37.5%). 100% of adults obtained organs from cadaveric donors, in pediatric patients 50% received organs from cadaveric donors, and 50% from living donors. During hospitalization, 1 renal graft failure and 1 rejection occurred in adults, without observing liver losses. Two pediatric patients died from sepsis and multiple organ failure. In conclusion, this preliminary report shows that TSHR at our institution has satisfactory clinical results comparable to those reported in the literature