Kidney and Pancreas Transplantation: Detailed Surgical Procedures and Management Protocols / Edition 2

by Ingemar J.A. Davidson

Overview

This book addresses peritransplant surgical management aspects in general, with emphasis on detailed intraoperative surgical technique. This is displayed in the detailed graphic representation which is the result of many hours of communication from the surgeon's view to the illustrator's hand. When writing this book, the authors have mainly had the young training surgeon in mind; however, this handbook will prove a valuable resource for many, including operating room personnel, transplant coordinators and transplant nephrologists.

Product Details

ISBN-13:	9781570596469
Publisher:	Taylor & Francis
Publication date:	08/28/1999
Series:	Handbooks Series
Edition description:	2ND
Pages:	228
Product dimensions:	8.00(w) x 5.00(h) x 0.50(d)

About the Author

Davidson, Ingemar J.A., MD, PhD, FACS (Medical City Dallas Hospital)

Table of Contents

1. Kidney/Pancreas Transplantation:   General Considerations and Current Issues 1
Ingemar J.A. Davidson
United Network for Organ Sharing 1
The End Stage Renal Disease (ESRD) Timeline 3
A Single-Organ Shock Model 4
Outcome Measures of Kidney Transplant 6
The Importance of Outcome Variable Selection 7
The Operating Room 7
Selected Management Issues   
in Kidney/Pancreas Transplantation 19
Common Surgical Procedures in ESRD Patients 21

Ingemar J.A. Davidson, Arthur I. Sagalowsky
Illustrations: Stephen Brown
The Multi-organ Procurement Procedure 25
The Two Stages of Back-table Work 25
The Kidney Transplant Recipient Operation 36
The Ureteral Neocystostomy 45
Closure of the Abdomen 50

Ingemar J.A. Davidson
Illustrations: Stephen Brown
Back-table Work in the Organ Recovery Operating Room 51
Back -table Work in the Recipient Operating Room 51
Steps in Back-table Work 52
The Pancreas Implantation 56
Exocrine Drainage 63
Surgical Complications After Pancreas Transplantation 65

Michael Edye, Robert Waterhouse
Introduction 73
Personnel and Equipment 73
Preoperative Work-Up 75
Surgical Technique 76
Donor Position 76
Left Nephrectomy 76
Coordination With Recipient Team 83
Final Preparation of the Donor Kidney 83
Right Nephrectomy 87
Technique 88
Termination 90
After Care 90
Complication Prevention 91
Conversion to Laparotomy 92

and Evaluation for Transplant 93
Maureen Ulrich, Laura Coorpender, Karen Paolini, Susan P. Graham
Background 93
Protocols Improve Outcome 94
When to Refer for Transplant 95
Patients Approaching End Stage Renal Disease (ESRD) 96
Evaluation of ESRD Patients for Transplantation 96
Transplant Team Member Functions 97
Maintaining Patients While on the Waiting List 98
Cardiac Evaluation for Kidney/Pancreas Transplant 99
Living Donor Evaluation 105

Ingemar J.A. Davidson, Christopher Lu, Carolyn Munschauer,   
Rabie Stephan, Maureen Ulrich
Perioperative Transplant Coordination 107
Preoperative Orders 109
Intraoperative Fluid and Drug Protocols 110
Postoperative Orders and Management 121
Drugs Affecting Early Kidney Function 125
The Immunosuppression Protocols 126
Posttransplant Renal Allograft Dysfunction 130
The Immunosuppression Protocol Timeline 133

Transplantation: General Policies and Procedures 137
Thomas Shanahan
HLA Typing 137
HLA Antibody Screening 139
Crossmatch Testing 140

Edwin Jenis, Ihsan Housini
Introduction 143
Handling of the Transplant Kidney Biopsy 144
Frozen Section 145
Pathology of Renal Transplantation 145
Cyclosporine Nephrotoxicity 148
Other Pathologic Changes Affecting the Transplanted Kidney 150
Perfusion Nephropathy 151
Posttransplant Lymphoproliferative Disease 151

and Kidney/Pancreas Transplants 153
George Miller, Michael Wallace
Angiography 153
Percutaneous Balloon Dilation   
of Collecting System Obstructions 157
The Evaluation of Pancreas Transplants 158

and Pancreas Transplant 161
Anthony Setiawan
Introduction 161
Terminology 161
The Renal Transplant 163
Pancreas Transplant 185
Ultrasound Guided Aspiration and Drainage 187

Arthur I. Sagalowsky
Anatomic Considerations 189
Urine Leak 191
Ureteral Obstruction 195
Lymphocele 198
Hydrocele 203
Erectile Dysfunction 203
Summary 203
and Kidney/Pancreas Transplantation 205
Lucille A. LoTempio
Introduction 205
Immunosuppressive Agents 206
Other Induction Therapies 210
Complications Secondary to Immunosuppression Infection 211
Over-the-Counter Agents 218
Conclusion 219

Editorial Reviews

Reviewer: John Paige, MD (Washington University School of Medicine)
Description: This second edition is the most recent publication in the Landes Bioscience Vademecum series of clinical handbooks created to provide practical guides on specialized topics in medicine. This book is a review of the technical and management issues of kidney and pancreas transplantation with emphasis on the editor's preferred therapies.
Purpose: It is intended to serve as a practical guide to assist in the day-to-day treatment of kidney and pancreas recipients, and the editor succeeds in providing an overview of his approach to operative and post-operative care.
Audience: This is a handbook targeted for the surgeon in training, especially the junior house staff officer. As the Surgical Director of the Renal and Transplant Program at the Medical City Dallas Hospital, the editor is a credible authority on the subject matter.
Features: Particular attention is devoted to the technical aspects of kidney and pancreas transplantation, and this is a particular strength. Nearly half the book is devoted to detailed review of the various techniques needed for cadaveric harvest, transplantation, and laparoscopic-assisted living donor nephrectomy. These chapters have excellent illustrations showing exposures, anastomotic techniques, and final results. In addition, the various instruments involved are shown in photographs, although a bit close cropped. The remainder of the book is a review of protocols, outcomes, imaging studies, and certain complications. These sections are the weaker ones of the handbook. The protocols are mainly those of the editor's and certain graphs and images, especially the ultrasounds, are difficult to read. Finally, the chapter on laparoscopic living donor nephrectomy seems out of place, since the open technique is not reviewed.
Assessment: This handbook is a useful technical guide to kidney and pancreas transplant. However, the editor relies too heavily on institutional protocols, making the management section less useful to the reader.

Doody's Review Service

2 Stars from Doody

This second edition is the most recent publication in the Landes Bioscience Vademecum series of clinical handbooks created to provide practical guides on specialized topics in medicine. This book is a review of the technical and management issues of kidney and pancreas transplantation with emphasis on the editor's preferred therapies. It is intended to serve as a practical guide to assist in the day-to-day treatment of kidney and pancreas recipients, and the editor succeeds in providing an overview of his approach to operative and post-operative care. This is a handbook targeted for the surgeon in training, especially the junior house staff officer. As the Surgical Director of the Renal and Transplant Program at the Medical City Dallas Hospital, the editor is a credible authority on the subject matter. Particular attention is devoted to the technical aspects of kidney and pancreas transplantation, and this is a particular strength. Nearly half the book is devoted to detailed review of the various techniques needed for cadaveric harvest, transplantation, and laparoscopic-assisted living donor nephrectomy. These chapters have excellent illustrations showing exposures, anastomotic techniques, and final results. In addition, the various instruments involved are shown in photographs, although a bit close cropped. The remainder of the book is a review of protocols, outcomes, imaging studies, and certain complications. These sections are the weaker ones of the handbook. The protocols are mainly those of the editor's and certain graphs and images, especially the ultrasounds, are difficult to read. Finally, the chapter on laparoscopic living donor nephrectomy seems out of place,since the open technique is not reviewed. This handbook is a useful technical guide to kidney and pancreas transplant. However, the editor relies too heavily on institutional protocols, making the management section less useful to the reader.

John Paige

Addresses peritransplant surgical managements in general, with emphasis on detailed intraoperative surgical technique. Special attention is paid to establishment of pretransplant guidelines for predialysis patients. When possible, alternate commonly used methods and surgical techniques are mentioned or referenced. Includes detailed b&w drawings illustrating surgical techniques, plus b&w results of medical imaging techniques. Useful for surgeons in training, operating room personnel, transplant coordinators, and internal medicine transplant physicians. Wire comb binding, 5x8<">. Annotation c. Book News, Inc., Portland, OR (booknews.com)

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