Perioperative management of pediatric renal transplantation

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Imane Failal, S Ezzaki, N Mtioui, S Khayat, M Zamed, G Medkouri, M Benghanem and B Ramdani

University Hospital Center Ibn Rochd- Casablanca, Morocco

: J Nephrol Ren Dis

Abstract

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Introduction & Objective: In kidney transplantation, the immediate per and postoperative period is a critical period for patient and graft survival. The objective of our study is to highlight the different modalities of anaesthesia and resuscitation in the context of the management of renal transplantation from a living donor.

Method: We conducted a retrospective study on all kidney transplant patients admitted to the Nephrology Department of Ibn Rochd University Hospital in Casablanca between June 2007 and March 2019 in consultation with the paediatric anaesthesia and paediatric resuscitation Department at Abderrahim El Harouchi Paediatric University Hospital of Casablanca.

Results: The age of our patients ranged from 5 to 17 with an average age of 11 years. The sex ratio was 1.2 with 11 boys and 9 girls. Initial nephropathy dominated by congenital malformations. A history of hypertension was found in 45% of patients. The infectious antecedents were found in 45% of the cases. The surgical history was found in 40% of cases. At the time of the transplant, 19 patients had undergone dialysis for at least six months. Renal transplantation was pre-emptive in one patient. Regarding the systemic impact, the majority of our patients had a failure to thrive. All patients underwent a complete clinical examination and further investigations after which dedifferentiated kidneys without other abnormalities on ultrasound found in 80% of patients. Immediate follow-up was simple for 65% of patients. In the medium and long term, 8 patients experienced complications including peritonitis, CMV infection and hemothorax. All these complications have been treated with a good evolution later.

Conclusion: A general mobilization must be carried out to establish the infrastructure and the human and technical necessary resources to care children with end-stage of renal failure; this could be accomplished through kidney transplantation, promotion of organ donation to allow patients with chronic renal failure to access to the best treatment that can currently be offered.

Biography

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Imane Failal is a Nephrology Resident at the ibn rochd university and hospital center in Casablanca, Morocco