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Effect of enhanced recovery after surgery on recovery after renal transplantation

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Author:
No author available
Journal Title:
China Clinical Practical Medicine
Issue:
6
DOI:
10.3760/cma.j.cn115570-20220822-01914
Key Word:
肾移植;快速康复外科;终末期肾病;降钙素原;围术期;Renal transplantation;Enhanced rehabilitation surgery;Perioperative period of kidney transplantation;Procalcitonin;Perioperative period

Abstract: Objective:To explore the Effect of enhanced recovery after surgery(ERAS)on recovery after renal transplantation.Methods:This study was a retrospective study.A total of 45 kidney transplant patients with ERAS admitted to the Organ Transplant Center of the General Hospital of Northern Theater Command from April 2021 to December 2021 were selected as the ERAS group, including 28 males and 17 females.The average age was(40.84±6.89)years old, ranging from 31 to 56 years old.Another 56 patients who received traditional renal transplantation during the same period were selected as the traditional group, 34 males and 22 females.The average age was(41.80±7.86)years old, ranging from 30 to 57 years old.Patients in ERAS group received ERAS regimen for perioperative management, while patients in traditional group received traditional perioperative management.Postoperative recovery, complications, serum creatinine level, procalcitonin and visual analogue scale(VAS)were compared between the two groups.Results:The recovery time of ERAS group[(12.53±1.76)d]was shorter than that of traditional group[(23.50±2.74)d], and the difference was statistically significant( P<0.05).All patients were followed up for 6 to 12 months.There was no death in ERAS group, and one patient had acute rejection.In the traditional group, one patient underwent renal graft resection due to graft artery embolization, and one patient had acute rejection.The incidence of postoperative complications in ERAS group[15.6%(7/45)]was lower than that in traditional group[32.1%(18/56)], and the difference was statistically significant( P<0.05).There was no significant difference in survival analysis results between the two groups( P>0.05).postoperative 1, 3 and 7 day, the calcitonin raw water of patients in ERAS group[(5.04±1.08)μg/L、(1.59±0.46)μg/L、(0.21±0.08)μg/L]was lower than that in traditional group[(6.14±1.46)μg/L、(2.29±1.11)μg/L、(0.36±0.20)μg/L], and the difference were statistically significant( P<0.05).At 3 days after operation, the VAS of patients in ERAS group[(1.65±0.27)scores]was lower than that in traditional group[(1.93±0.38)scores], and the difference was statistically significant( P<0.05).Pain may affect the prognosis of the transplanted kidney. Conclusions:ERAS is safe and feasible in cadaveric kidney transplantation, which is worthy of clinical application.

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