Hemodialysis for patients with cadaveric renal transplantation

Abstract

Cadaver donor kidney transplantation is often necessary for semiemergency juroery and differs from living donor kidney transplantation. Therefore, preoperative hemodialysis is also necessary for semiemergency operations in many cases, and there are also many patients in whom hemodialysis in necessary due to ATN after the operation. In the present study, we experienced 39 cases of cadaver donor kidney transplantation and obtained the following conclusions concerning hemodialysis for patients with cadaver donor kidney transplantation.
1) We paid attention to the following points for preoperative hemodialysis.
a) The coagulation time was ditermined, and heparin volume was made as small as possible.
b) Ht 30-35% was as a target transfused during the dialysis.
c) Predonine was administered after the finish of or two hours before the dialysis.
d) Sufficient conversations between nurses and patients were carried on during the dialysis so that the preoperative nursing could be conducted smoothly.
2) We paid attention to the following points for postoperative dialysis.
a) The dialysis was performed more than 24 hours after the operation, and the supplemental solution amount in the meantime was urinary amount plus 30ml/hr. Ion exchange resins and glucose insulin therapies were made against hypercalcemia.
b) The coagulation time was measured as a short and frequent dialysis in the early stage after the operation.
c) Predonine was administered after the finish of or two hours before the dialysis.
d) Scintiscan using ⁹⁹Tc-DTPA was conducted twice a week in order to discover acute rejection during ATN early on.
e) In particular, no isolated dialysis was carried out.
3) Complications due to the dialysis were not particularly noted, 34 out of 39 cases (87.2%) with cadaver donor kidney transplantation could teammate the dialysis, and the maximal dialytic period was 42 days.