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Anestesia no transplante de rim de doador vivo no Hospital das Clínicas de Botucatu: fatores de influência para o desfecho

Authors: Oliva, Verusca Michele;

Anestesia no transplante de rim de doador vivo no Hospital das Clínicas de Botucatu: fatores de influência para o desfecho

Abstract

Aim: to study the factors that influenced the success of living donor kidney transplant. Methods: analytical retrospective cohort study analyzing School Hospital records of 160 renal recipients and their donors. Pre-anesthetic evaluation data, anesthesia and anesthetics used were studied for donor and recipient. Exclusively for the recipient, time of warm and cold ischemia, postoperative complications and transplant evolution regarding creatinine (Cr), 50% decrease within 24h and normalization up to 119h, as well as the relation of such evolution with discharge were also studied. Statistical analysis: Poisson regression with step wise with backward elimination. Results: for the recipients, with 95% confidence interval: protective factors for Cr initial decrease, arterial hypertension, prevalence ratio (PR) 0,49 (0,26-0,92), p=0,020, inhalational anesthesia, PR 0,36 (0,18-0,69), p 20 years old [between 30-39 years old, PR 8,84 (2,05-38,11), p=0,003], cold ischemia time > 120min, PR 1,87 (1,06-3,29), p=0,020. Without proper Cr initial decrease there was > hospitalization period. Conclusion: for the recipient, protective factors to Cr initial decrease were previous hypertension and inhalational anesthesia, and to Cr normalization, age < 20 years old and adequate cold ischemia time. With proper Cr initial decrease, the patient can be discharged in a shorter time.

Objetivo: estudar fatores que influenciaram o sucesso do transplante renal de doador vivo. Métodos: estudo de coorte retrospectiva analítica - prontuários de Hospital Universitário de 160 receptores de rins e seus doadores. No doador e receptor, estudaram-se dados de avaliação pré-anestésica, anestesia e anestésicos empregados e, no receptor, tempos de isquemia quente e fria, complicações no pós-operatório, evolução do TX quanto à creatinina sérica (Cr) - redução de 50% em 24h e normalização em até 119h - e relação desses comportamentos com alta hospitalar. Análise estatística: regressão de Poisson com técnica de passos para trás. Resultados: nos receptores, com intervalo de confiança 95%: fatores protetores para redução inicial da Cr, hipertensão arterial, razão de prevalência (RP) 0,49 (0,26-0,92), p=0,020, anestesia inalatória, RP 0,36 (0,18-0,69), p 20 anos [entre 30-39 anos, RP 8,84 (2,05-38,11), p=0,003], tempo de isquemia fria > 120min, RP 1,87 (1,06-3,29), p=0,020. Sem redução inicial esperada da Cr, ocorreu alta hospitalar tardia. Conclusão: no receptor, foram fatores protetores para iniciar redução da Cr, hipertensão prévia e anestesia inalatória e, para sua normalização, idade < 20 anos e tempo adequado de isquemia fria. Com redução inicial da Cr a alta pode ocorrer em menor tempo.

Pós-graduação em Anestesiologia - FMB

Country
Brazil
Keywords

Kidney transplantation, Anestesia por inalação, Inhalation, Transplante de rim, Creatinine, Creatinina, Anesthesia, Living donors, Doadores vivos

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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