Peri operative anaesthetic challenges on live related renal transplant patients at the Kenyatta National Hospital

Abstract

Background The perioperative period is a critical time and impacts on the outcome/ survival of the renal graft. Over half of the patients undergoing kidney transplant surgery have at least one comorbid condition, most commonly diabetes mellitus, hypertension, congestive heart failure, coronary artery disease, pulmonary disease, or a previous rnaliqnancy'. This makes renal transplantation a challenge to the anaesmeetoloqet and the peri operative period critical as it impacts on the overall outcome of the graft.

Objectives To study the perioperative challenges related to anaesthesia experienced in renal transplantation at Kenyatta National Hospital

Methodology This was a cross sectional prospective observational study. Data was collected by administering a questionnaire during the perioperative period to appropriate candidates. 31 kidney recipients and 31 kidney donors undergoing kidney transplantation at the Kenyatta National Hospital main theatre (KNH) were recruited. Informed consent was taken preoperatively and patients were followed up and data collected both intraoperatively and postoperatively.

Results All our patients had at least one co morbid issue. We had a high rate of perioperative anaemia necessitating blood transfusion. 91 % of our patients had systemic hypertension preoperatively and were on treatment. Diabetes was seen in 35.5% of the patients. We also had patients with vascular challenges. Overall. the patients did well during the perioperative period and we had a high graft survival rate.