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Chapter-30 Implantation

BOOK TITLE: Kidney & Pancreas Transplantation

Author
1. Molmenti Ernesto P
ISBN
9789351523390
DOI
10.5005/jp/books/12547_31
Edition
1/e
Publishing Year
2015
Pages
22
Author Affiliations
1. Hofstra Northwell School of Medicine, Long Island, New York, USA, North Shore-LIJ Health System, Long Island, New York, USA; Hofstra North Shore–LIJ School of Medicine, Long Island, New York, USA
Chapter keywords
vascular implantation, ureteral implantation, abdominal closure, anastomosis, hyperkalemia, lymphoceles, intraperitoneal drainage

Abstract

This chapter discusses about kidney implantation, where complete blood count, electrolytes, all other preoperative requirements, and availability of the correct allograft are addressed and confirmed prior to starting the procedure. Kidney implantation includes vascular implantation, ureteral implantation, and abdominal closure. Routinely administer subcutaneous heparin immediately prior to Implantation, and maintain sequential compression devices on both lower extremities. Some surgeons prefer to purposefully open the peritoneum and subsequently close it in order to allow for the intraperitoneal drainage of potential seromas or lymphoceles. After completion of the anastomosis, a bulldog clamp is placed on the renal vein and the semicircular clamp on the iliac vein is partially released during vascular implantation. Cardiac arrest at the time of reperfusion should be attributed to hyperkalemia until proven otherwise, where all necessary treating agents, such as calcium chloride, calcium gluconate, insulin with glucose should be readily available.

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