{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T21:29:01Z","timestamp":1788557341174,"version":"build-2803163510"},"reference-count":11,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,8,18]],"date-time":"2016-08-18T00:00:00Z","timestamp":1471478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Hospital Research Ethics Board","award":["100020424"],"award-info":[{"award-number":["100020424"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Smaller children are presenting for renal transplantation as the treatment of choice for end\u2010stage renal disease. Adult donor organs are more successful than pediatric deceased donor organs. An adult kidney may sequester ~75% of the circulating volume of a 5 year\u2010old child and requires significantly increased cardiac output to maintain renal perfusion. Treatment includes volume, inotropic or vasopressor agents, or central neuroaxial blockade for sympatholysis.<\/jats:p><jats:p>We describe the perioperative anesthestic management as a guide to clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective chart review of renal transplant patients between 2006 and 2014 was performed. We recorded patient demographics, surgical and anesthetic factors and postoperative outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and fifty\u2010six children underwent renal transplantation, of which 38% were from living donors. There were 99\/156 (63.5%) males. Median age was 10 years (range 1\u201317 years) and the mean weight was 36.2 kg (<jats:styled-content style=\"fixed-case\">sd<\/jats:styled-content> 20.6 kg; range 7.6\u2013109.6 kg). There were 36 children \u22645 years of age and 14 children \u22642 years of age. One hundred and nineteen (77%) were dialysis dependent.<\/jats:p><jats:p>Pharmacological support to increase renal perfusion included mannitol in 95%, and dopamine in 83%. Furosemide was used in 82% of cases. Inotropic therapy continued into the postoperative period in 34%. Radiological pulmonary edema was diagnosed in 33% and clinical pulmonary edema in 7%. Intraoperative use of dopamine delayed the time to creatinine nadir in all grafts (9.5 days vs 6.5 days, <jats:italic>P<\/jats:italic> = 0.04) and in deceased donor grafts (12.9 vs 7.4 days, <jats:italic>P<\/jats:italic> = 0.007). Patients who received dopamine had no significant difference in central venous pressure (CVP) preclamp removal, 14 mmHg vs 11.5 mmHg (<jats:italic>P<\/jats:italic> = 0.12) but a higher <jats:styled-content style=\"fixed-case\">CVP<\/jats:styled-content> after clamp removal, 14.3 mmHg vs 11.8 mmHg (<jats:italic>P<\/jats:italic> = 0.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Dopamine use was common and was an independent risk factor for delayed time to creatinine nadir. Many different agents were used to enhance renal perfusion. The \u2018supra\u2010physiological\u2019 hemodynamics resulted in pulmonary edema in 33% of patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12979","type":"journal-article","created":{"date-parts":[[2016,8,18]],"date-time":"2016-08-18T05:46:56Z","timestamp":1471499216000},"page":"987-991","source":"Crossref","is-referenced-by-count":33,"title":["Intraoperative management and early postoperative outcomes of pediatric renal transplants"],"prefix":"10.1111","volume":"26","author":[{"given":"Katherine","family":"Taylor","sequence":"first","affiliation":[{"name":"Department of Anesthesia Hospital for Sick Children Toronto Canada"},{"name":"Department of Anesthesia University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wooheon Thomas","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Hospital for Sick Children Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malak","family":"Maharramova","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Hospital for Sick Children Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital for Sick Children Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smruthi","family":"Ramesh","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Hospital for Sick Children Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Lorenzo","sequence":"additional","affiliation":[{"name":"Department of Urology Hospital for Sick Children Toronto Canada"},{"name":"Department of Surgery University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,8,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1314376"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199112000-00009"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2006.03.007"},{"key":"e_1_2_10_5_1","unstructured":"KraneE.Guidelines for anaesthesia for pediatric renal transplantation. Available at:http:\/\/med.stanford.edu\/pedsanesthesia\/downloads\/guideline-renal.pdf. Accessed 8 July 2016."},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200108000-00005"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-002-1346-y"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2003.09.005"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2009.08.058"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12726"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13666"},{"key":"e_1_2_10_12_1","first-page":"270","article-title":"Anesthesia for kidney transplantation \u2013 a review","volume":"4","author":"Martinez BS","year":"2013","journal-title":"Anesthesia Clin Res"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpan.12979","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.12979","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T16:41:29Z","timestamp":1696178489000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.12979"}},"subtitle":[],"editor":[{"given":"Jerrold","family":"Lerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2016,8,18]]},"references-count":11,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2016,10]]}},"alternative-id":["10.1111\/pan.12979"],"URL":"https:\/\/doi.org\/10.1111\/pan.12979","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8,18]]}}}