Yıl: 2021 Cilt: 51 Sayı: 3 Sayfa Aralığı: 1234 - 1239 Metin Dili: İngilizce DOI: 10.3906/sag-2012-291 İndeks Tarihi: 18-01-2022

Evaluation of the learning curve of pediatric kidney transplantation anesthesia

Öz:
Background/aim: Pediatric kidney transplantation (PKT) anesthesia brings some different challenges than adult kidney transplantation (KT) anesthesia and there are still no studies analyzing the role of experience on PKT outcomes. In this study, we aimed to evaluate the anesthesia learning curve in pediatric kidney transplants performed in our institution and the effect of increasing experience on renal transplantation-related data. Materials and methods: Patients age ≤ 18 years who underwent KT were included in the study, while patients age >18 years were excluded. Patients were divided into 3 groups according to the date of transplant, as the first 10 patients in Group 1, the second 10 patients in Group 2, and the final 11 in Group 3. Groups were compared according to recorded data. Results: Thirty-one patients were included in the study. Age, sex, and body mass index were matched between the 3 groups. The mean durations of dialysis were 75.0 ± 63.0, 22.4 ± 27.9, and 5.7 ± 4.5 months for Group 1, Group 2, and Group 3, respectively (p = 0.009). Blood loss, duration of postoperative mechanical ventilation, and length of stay in the intensive care unit (ICU) were comparable between the groups. The duration of anesthesia gradually shortened from Group 1 to Group 3 but there was no significant difference between the groups. The mean number of red blood cell (RBC) transfusion was 0.9 ± 0.7 unit in group 1. It decreased to a mean of 0.6 ± 0.7 unit for group 2, and afterward significant decrease occurred down to 0 for group 3 (p = 0.004). Conclusion: Our results demonstrate that considering the decrease in preoperative dialysis duration and operative RBC transfusion, 20 patients may be enough for anesthesia competency. Transplantation anesthesia experience before PKT, anesthesia technique, and patient characteristics may differ between institutions. Therefore, further prospective studies with established learning curve goals, larger patient volumes, and more variables are needed to validate our results.Key words: Anesthesia, chronic kidney failure, kidney transplantation, learning curve, pediatrics
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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  • 1. Hariharan S, Johnson CP, Bresnahan BA, Taranto SE, McIntosh MJ et al. Improved graft survival after renal transplantation in the United States, 1988 to 1996. The New England Journal of Medicine 2000; 342 (9): 605-612. doi: 10.1056/ NEJM200003023420901
  • 2. SarinKapoor H, Kaur R, Kaur H. Anaesthesia for renal transplant surgery. Acta Anaesthesiologica Scandinavica 2007; 51 (10): 1354-1367. doi: 10.1111/j.1399-6576.2007.01447.x
  • 3. Antunes H, Parada B, Tavares-da-Silva E, Carvalho J, Bastos C et al. Pediatric renal transplantation: evaluation of long-term outcomes and comparison to adult population. Transplantation Proceedings 2018; 50 (5): 1264-1271. doi: 10.1016/j.transproceed.2018.02.089
  • 4. Vial F, Mory S, Guerci P, Grandjean B, Petry L et al. Evaluating the learning curve for the transversus abdominal plane block: a prospective observational study. Canadian Journal of Anaesthesia 2015; 62 (6): 627-633 (in French). doi: 10.1007/ s12630-015-0338-7
  • 5. Weil G, Motamed C, Biau DJ, Guye ML. Learning curves for three specific procedures by anesthesiology residents using the learning curve cumulative sum (LC-CUSUM) test. Korean Journal of Anesthesiology 2017; 70 (2): 196-202. doi: 10.4097/ kjae.2017.70.2.196
  • 6. Voet M, Nusmeier A, Lerou J, Luijten J, Cornelissen M et al. Cardiac output-guided hemodynamic therapy for adult living donor kidney transplantation in children under 20 kg: a pilot study. Paediatric Anaesthesia 2019; 29 (9): 950-958. doi: 10.1111/pan.13705
  • 7. Hadimioglu N, Ulugol H, Akbas H, Coskunfirat N, Ertug Z et al. Combination of epidural anesthesia and general anesthesia attenuates stress response to renal transplantation surgery. Transplantation Proceedings 2012; 44 (10): 2949-2954. doi: 10.1016/j.transproceed.2012.08.004
  • 8. Mehrabi A, Golriz M, Khajeh E, Ghamarnejad O, Kulu Y et al. Surgical outcomes after pediatric kidney transplantation at the University of Heidelberg. Journal of Pediatric Urology 2019; 15 (3): 221.e1-221.e8. doi: 10.1016/j.jpurol.2019.01.007
  • 9. Ahlawat RK, Tugcu V, Arora S, Wong P, Sood A et al. Learning curves and timing of surgical trials: robotic kidney transplantation with regional hypothermia. Journal of Endourology 2018; 32 (12): 1160-1165. doi: 10.1089/ end.2017.0697
  • 10. Odeh RI, Sidler M, Skelton T, Zu’bi F, Naoum NK et al. Intraoperative blood transfusion in pediatric patients undergoing renal transplant - effect of renal graft size. Pediatric Transplantation 2018; 22 (3): e13119. doi: 10.1111/petr.13119
  • 11. Sadaghdar H, Chelluri L, Bowles SA, Shapiro R. Outcome of renal transplant recipients in the ICU. Chest 1995; 107 (5): 1402-1405. doi: 10.1378/chest.107.5.1402
  • 12. Krell RW, Girotti ME, Dimick JB. Extended length of stay after surgery: complications, inefficient practice, or sick patients? JAMA Surgery 2014; 149 (8): 815-820. doi: 10.1001/ jamasurg.2014.629
  • 13. Dias BH, Rana AAM, Olakkengil SA, Russell CH, Coates PTH et al. Development and implementation of an enhanced recovery after surgery protocol for renal transplantation. ANZ Journal of Surgery 2019; 89 (10): 1319-1323. doi: 10.1111/ ans.15461
  • 14. Resende L, Guerra J, Santana A, Mil-Homens C, Abreu F et al. Influence of dialysis duration and modality on kidney transplant outcomes. Transplantation Proceedings 2009; 41 (3): 837-839. doi: 10.1016/j.transproceed.2009.01.063
  • 15. Goto N, Okada M, Yamamoto T, Tsujita M, Hiramitsu T et al. Association of dialysis duration with outcomes after transplantation in a Japanese cohort. Clinical Journal of the American Society of Nephrology 2016; 11 (3): 497-504. doi: 10.2215/CJN.08670815
  • 16. Lofaro D, Jager KJ, Abu-Hanna A, Groothoff JW, Arikoski P et al. Identification of subgroups by risk of graft failure after paediatric renal transplantation: application of survival tree models on the ESPN/ERA-EDTA registry. Nephrology, Dialysis, Transplantation 2016; 31 (2): 317-324. doi: 10.1093/ ndt/gfv313
  • 17. Samuel SM, Tonelli MA, Foster BJ, Alexander RT, Nettel-Aguirre A et al. Survival in pediatric dialysis and transplant patients. Clinical Journal of the American Society of Nephrology 2011; 6 (5): 1094-1099. doi: 10.2215/CJN.04920610
APA Uludag Yanaral T, Karaaslan P (2021). Evaluation of the learning curve of pediatric kidney transplantation anesthesia. , 1234 - 1239. 10.3906/sag-2012-291
Chicago Uludag Yanaral Tumay,Karaaslan Pelin Evaluation of the learning curve of pediatric kidney transplantation anesthesia. (2021): 1234 - 1239. 10.3906/sag-2012-291
MLA Uludag Yanaral Tumay,Karaaslan Pelin Evaluation of the learning curve of pediatric kidney transplantation anesthesia. , 2021, ss.1234 - 1239. 10.3906/sag-2012-291
AMA Uludag Yanaral T,Karaaslan P Evaluation of the learning curve of pediatric kidney transplantation anesthesia. . 2021; 1234 - 1239. 10.3906/sag-2012-291
Vancouver Uludag Yanaral T,Karaaslan P Evaluation of the learning curve of pediatric kidney transplantation anesthesia. . 2021; 1234 - 1239. 10.3906/sag-2012-291
IEEE Uludag Yanaral T,Karaaslan P "Evaluation of the learning curve of pediatric kidney transplantation anesthesia." , ss.1234 - 1239, 2021. 10.3906/sag-2012-291
ISNAD Uludag Yanaral, Tumay - Karaaslan, Pelin. "Evaluation of the learning curve of pediatric kidney transplantation anesthesia". (2021), 1234-1239. https://doi.org/10.3906/sag-2012-291
APA Uludag Yanaral T, Karaaslan P (2021). Evaluation of the learning curve of pediatric kidney transplantation anesthesia. Turkish Journal of Medical Sciences, 51(3), 1234 - 1239. 10.3906/sag-2012-291
Chicago Uludag Yanaral Tumay,Karaaslan Pelin Evaluation of the learning curve of pediatric kidney transplantation anesthesia. Turkish Journal of Medical Sciences 51, no.3 (2021): 1234 - 1239. 10.3906/sag-2012-291
MLA Uludag Yanaral Tumay,Karaaslan Pelin Evaluation of the learning curve of pediatric kidney transplantation anesthesia. Turkish Journal of Medical Sciences, vol.51, no.3, 2021, ss.1234 - 1239. 10.3906/sag-2012-291
AMA Uludag Yanaral T,Karaaslan P Evaluation of the learning curve of pediatric kidney transplantation anesthesia. Turkish Journal of Medical Sciences. 2021; 51(3): 1234 - 1239. 10.3906/sag-2012-291
Vancouver Uludag Yanaral T,Karaaslan P Evaluation of the learning curve of pediatric kidney transplantation anesthesia. Turkish Journal of Medical Sciences. 2021; 51(3): 1234 - 1239. 10.3906/sag-2012-291
IEEE Uludag Yanaral T,Karaaslan P "Evaluation of the learning curve of pediatric kidney transplantation anesthesia." Turkish Journal of Medical Sciences, 51, ss.1234 - 1239, 2021. 10.3906/sag-2012-291
ISNAD Uludag Yanaral, Tumay - Karaaslan, Pelin. "Evaluation of the learning curve of pediatric kidney transplantation anesthesia". Turkish Journal of Medical Sciences 51/3 (2021), 1234-1239. https://doi.org/10.3906/sag-2012-291