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Review
. 2023 Nov;72(11):773-783.
doi: 10.1007/s00101-023-01332-x. Epub 2023 Oct 24.

[Anesthesia for organ transplant patients]

[Article in German]
Anna Fiala  1 , Robert Breitkopf  2 , Barbara Sinner  1 , Simon Mathis  1 , Judith Martini  1
Affiliations
Review

[Anesthesia for organ transplant patients]

[Article in German]
Anna Fiala et al. Anaesthesiologie. 2023 Nov.

Abstract
in English, German

Organ transplant patients who must undergo nontransplant surgical interventions can be challenging for the anesthesiologists in charge. On the one hand, it is important to carefully monitor the graft function in the perioperative period with respect to the occurrence of a possible rejection reaction. On the other hand, the ongoing immunosuppression may have to be adapted to the perioperative requirements in terms of the active substance and the route of administration, the resulting increased risk of infection and possible side effects (e.g., myelosuppression, nephrotoxicity and impairment of wound healing) must be included in the perioperative treatment concept. Furthermore, possible persistent comorbidities of the underlying disease and physiological peculiarities as a result of the organ transplantation must be taken into account. Support can be obtained from the expertise of the respective transplantation center.

Organtransplantierte Patient:innen, die sich einem operativen Eingriff unterziehen müssen, der nicht im Zusammenhang mit ihrer Transplantation steht, können die betreuenden Anästhesist:innen vor große Herausforderungen stellen. Einerseits gilt es, die Transplantatfunktion in der perioperativen Phase sorgfältig hinsichtlich des Auftretens einer etwaigen Abstoßungsreaktion zu überwachen. Andererseits müssen die laufende Immunsuppression ggf. bezüglich des Wirkstoffes und/oder des Applikationsweges den perioperativen Erfordernissen angepasst sowie das sich aus ihr ergebende erhöhte Infektionsrisiko und mögliche Nebenwirkungen (wie z. B. Myelosuppression, Nephrotoxizität, Beeinträchtigung der Wundheilung usw.) in das perioperative Behandlungskonzept integriert werden. Des Weiteren sind möglicherweise persistierende Komorbiditäten der Grunderkrankung sowie physiologische Spezifika infolge der Organtransplantation zu beachten. Hierbei kann auf die Expertise das jeweiligen Transplantationszentrums zurückgegriffen werden.

Keywords: Immunosuppression; Infection; Monitoring; Perioperative management; Prophylaxis; Rejection.

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References

    1. Alatič J, Lindič J, Godnov U, et al. Arterial stiffness in renal transplant recipients: 5-year follow-up. Transplant Proc. 2021;53:2907–2912. doi: 10.1016/j.transproceed.2021.09.032. - DOI - PubMed
    1. Arroyo V. Pathophysiology, diagnosis and treatment of ascites in cirrhosis. Ann Hepatol. 2002;1:72–79. doi: 10.1016/S1665-2681(19)32178-7. - DOI - PubMed
    1. Ashary N, Kaye AD, Hegazi AR, et al. Anesthetic considerations in the patient with a heart transplant. Heart Dis. 2002;4:191–198. doi: 10.1097/00132580-200205000-00010. - DOI - PubMed
    1. Awad M, Czer LS, Hou M, et al. Early denervation and later reinnervation of the heart following cardiac transplantation: a review. J Am Heart Assoc. 2016;5:e004070. doi: 10.1161/JAHA.116.004070. - DOI - PMC - PubMed
    1. Backman SB, Stein RD, Blank DW, et al. Different properties of the bradycardia produced by neostigmine and edrophonium in the cat. Can J Anaesth. 1996;43:731–740. doi: 10.1007/BF03017959. - DOI - PubMed

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