Infusion-transfusion therapy and correction of water–electrolyte disorders in simultaneous liver fragment transplantation and kidney retransplantation (clinical case)

Q3 Medicine

Vestnik anesteziologii i reanimatologii Pub Date : 2023-10-24 DOI:10.24884/2078-5658-2023-20-5-54-61

D. I. Novikov, A. Yu. Zaitsev, O. E. Kut’ina, A. V. Filin, A. K. Zokoev, A. V. Metelin, S. V. Shchkaturov, M. Ya. Khalimov

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Abstract

A clinical case of simultaneous surgery in the volume of transplantation of the left lateral sector of the liver and kidney retransplantation from one living related donor to a 10-year-old girl with cirrhosis of the liver and after transplantectomy of the donor kidney is presented. The child born in 2013 was transferred to program hemodialysis in 2015 as a result of the development of end-stage chronic kidney disease (CKD) in the outcome of congenital kidney dysplasia. In October 2022, renal replacement therapy was started as a result of a relapse of end-stage CKD. In January 2023, she suffered purulent cystitis. 02.24.2023 – transplantectomy. 05.05.2023, simultaneous transplantation of the left lateral sector of the liver and kidney allotransplantation from a living related donor were performed. Anesthesiologists faced a serious problem in the form of the selection of adequate infusion therapy, taking into account the combination of two surgical interventions that radically differ in the tactics of anesthesiological support, as well as the correction of water – electrolyte disorders in the complete absence of diuresis throughout the fifteen-hour surgical intervention

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同时肝碎片移植肾再移植中输液治疗及水电解质紊乱的纠正(附临床病例)

本文报道一例同时进行肝左外侧部分移植的临床病例，并将一名活体亲属供体肾再移植给一名患有肝硬化的10岁女孩，并在供体肾切除后。2013年出生的孩子由于发展为终末期慢性肾脏疾病(CKD)而导致先天性肾发育不良，于2015年转入血液透析项目。2022年10月，由于终末期CKD复发，肾脏替代治疗开始。2023年1月，她患上化脓性膀胱炎。02.24.2023 -移植切除术。05.05.2023，同时进行左外侧肝移植和活体亲属供体肾异体移植。麻醉师面临着一个严重的问题，即选择适当的输注疗法，考虑到两种手术干预的组合，这两种手术干预在麻醉支持策略上根本不同，以及在15小时的手术干预中完全没有利尿的情况下纠正水电解质紊乱

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