심장 신장 동시 이식 수술 마취 관리 1례

Abstract

Cardiac and renal diseases are related physiologically and often co-exist in patients with either one disease. The population of patients with end-stage cardiac and renal diseases is growing, and the waiting lists for one or both organ transplantation continue to grow. Here, we describe the case of performing general anesthesia for combined heart and kidney transplantation. A 55-year-old male who has underlying diabetes mellitus, chronic kidney failure and heart failure was referred for combined heart and kidney transplantation. After the induction of general anesthesia, heart transplantation was done. Norepinephrine, epinephrine, and dobutamine infusions were initiated for the weaning from cardiopulmonary bypass. After heart transplantation, continuous renal replacement therapy was used in operation room. Kidney transplantation was done and the patient was sent to intensive care unit without extubation. The patient was discharged to general ward on postoperative day 6 after extubation. Since more patients require multi-organ transplantation, it is important for anesthesiologist to understand the physiology of underlying disease and the process of operation.