Infusion-transfusion therapy and correction of water–electrolyte disorders in simultaneous liver fragment transplantation and kidney retransplantation (clinical case)

Abstract

A clinical case of simultaneous surgery in the volume of transplantation of the left lateral sector of the liver and kidney retransplantation from one living related donor to a 10-year-old girl with cirrhosis of the liver and after transplantectomy of the donor kidney is presented. The child born in 2013 was transferred to program hemodialysis in 2015 as a result of the development of end-stage chronic kidney disease (CKD) in the outcome of congenital kidney dysplasia. In October 2022, renal replacement therapy was started as a result of a relapse of end-stage CKD. In January 2023, she suffered purulent cystitis. 02.24.2023 – transplantectomy. 05.05.2023, simultaneous transplantation of the left lateral sector of the liver and kidney allotransplantation from a living related donor were performed. Anesthesiologists faced a serious problem in the form of the selection of adequate infusion therapy, taking into account the combination of two surgical interventions that radically differ in the tactics of anesthesiological support, as well as the correction of water – electrolyte disorders in the complete absence of diuresis throughout the fifteen-hour surgical intervention

Keywords

• liver transplantation
• kidney transplantation
• simultaneous liver-kidney transplantation
• hyperkalemia
• lactate acidosis
• infusion therapy
• massive blood loss