Practice Variation in the Immediate Postoperative Care of Pediatric Kidney Transplantation: A National Survey

S. Abu-Sultaneh, M. J. Hobson, A. C. Wilson, W. C. Goggins, Mara Nitu, R. Lutfi

Research output: Contribution to journalArticle

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Abstract

Introduction Advances in organ allocation, surgical technique, immunosuppression, and long-term follow-up have led to a significant improvement in kidney transplant outcomes. Although there are clear recommendations for several aspects of kidney transplant management, there are no pediatric-specific guidelines for immediate postoperative care. The aim of this survey is to examine practice variations in the immediate postoperative care of pediatric kidney transplant patients. Methods We surveyed medical directors of Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)-affiliated pediatric intensive care units regarding center-specific immediate postoperative management of pediatric kidney transplantation. Results The majority of PALISI centers admit patients to the pediatric intensive care unit postoperatively, and 97% of the centers involve a pediatric nephrologist in immediate postoperative care. Most patients undergo invasive hemodynamic monitoring; 97% of centers monitor invasive arterial blood pressure and 88% monitor central venous pressure. Most centers monitor serum electrolytes every 4 to 6 hours. Wide variation exists regarding blood pressure goal, fluid replacement type, frequency of obtaining kidney ultrasound, and use of prophylactic anticoagulation. Conclusion There is consistent practice across PALISI centers in regards to many aspects of immediate postoperative management of pediatric kidney transplantation. However, variation still exists in some management aspects that warrant further discussions to reach a national consensus.

Original languageEnglish (US)
Pages (from-to)2060-2064
Number of pages5
JournalTransplantation Proceedings
Volume49
Issue number9
DOIs
StatePublished - Nov 1 2017

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Postoperative Care
Kidney Transplantation
Pediatrics
Acute Lung Injury
Kidney
Sepsis
Pediatric Intensive Care Units
Research Personnel
Transplants
Blood Pressure Monitors
Physician Executives
Central Venous Pressure
Surveys and Questionnaires
Immunosuppression
Electrolytes
Arterial Pressure
Hemodynamics
Guidelines
Blood Pressure
Serum

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Practice Variation in the Immediate Postoperative Care of Pediatric Kidney Transplantation : A National Survey. / Abu-Sultaneh, S.; Hobson, M. J.; Wilson, A. C.; Goggins, W. C.; Nitu, Mara; Lutfi, R.

In: Transplantation Proceedings, Vol. 49, No. 9, 01.11.2017, p. 2060-2064.

Research output: Contribution to journalArticle

Abu-Sultaneh, S. ; Hobson, M. J. ; Wilson, A. C. ; Goggins, W. C. ; Nitu, Mara ; Lutfi, R. / Practice Variation in the Immediate Postoperative Care of Pediatric Kidney Transplantation : A National Survey. In: Transplantation Proceedings. 2017 ; Vol. 49, No. 9. pp. 2060-2064.
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