Continuous spinal anaesthesia for kidney transplantation in a lupus patient with severe mitral regurgitation: A case report

Rev Esp Anestesiol Reanim (Engl Ed). 2024 Nov 12:101617. doi: 10.1016/j.redare.2024.101617. Online ahead of print.

Abstract

Anaesthesia for kidney transplant in a patient with severe mitral regurgitation is a real challenge given the need for judicious haemodynamic management to avoid pulmonary oedema and maximise reperfusion of the transplanted organ. This is the first experience described in the literature of continuous spinal anaesthesia in a patient with chronic severe mitral regurgitation undergoing cadaver donor kidney transplant. Transthoracic echocardiography monitoring was used during the procedure to avoid aggravating the patient's mitral regurgitation. Intraoperatively, 17.5 ml/kg of crystalloids were administered and no vasopressors were required. Continuous spinal anaesthesia preserved haemodynamics and graft perfusion during the procedure.

Keywords: Anestesia espinal continua; Anestesia neuroaxial; Continuous spinal anaesthesia; Echocardiography; Ecocardiografía; Haemodynamic management; Kidney transplantation; Manejo hemodinámico; Mitral regurgitation; Neuraxial anaesthesia; Regurgitación mitral; Trasplante renal.

Publication types

  • Case Reports