Download Peri-Operative Checklist for Organ Transplantation

Peri-Operative Checklist for Organ Transplantation
Anesthesiologist to review
each item with surgeon
before the surgery.
1. Chem 7, CBC, Type and Cross 2U confirmed prior to surgery.
2. Confirm ABO Type immediately prior to surgery
Recipient ABO Type _______ (from LifeLinks records)
(Living from LifeLinks; cadaveric
3.
4.
5.
6.
Anesthesiologist Initials ______
Surgeon Initials
_______
7.
8.
9.
10.
Anesthesiologist to review
each item with surgeon before
and during the surgery.
Medications given are to be
documented in the anesthesia
record.
Anesthesiologist Initials ______
Surgeon Initials
_______
Donor ABO Type
_______ from organ bank records)
Triple lumen catheter (prefer right IJ). If patient has a dialysis catheter
(PermCath, Tesio, etc.) this may be used. Aspirate heparin prior to access.
OG tube (for kidney transplants) or NG (for pancreas transplants)
Venodyne compression boots
Volume – Most patients require 2000 – 2500 before unclamp and renal
reperfusion. Patients who arrive wet (i.e. – last dialysis treatment was 2 or
3 days ago) may require less (1500 cc).
BP – Goal > 130 mm Hg at time of unclamp.
Biopsy – implantation renal biopsy performed by surgeon.
Note Off-ice time (time organ brought on to field for anastomosis) in
anesthesia record.
Note Reperfusion time (vascular clamps removed) in anesthesia record.
1. Cefazolin 1 g IV (for kidney transplants)
Cefotetan 1 g IV (for pancreas transplants)
Vancomycin 1000 mg IV over 30 minutes if allergic
2. Solumedrol 500 mg IV
3. Thymoglobulin infusion: Check with surgeon for dose. DOSE - ____ mg.
Premedicate with Solumedrol (500 mg) before beginning infusion.
Infusion pump required – administer over 6-8 hours.
Must administer via CVL.
Simulect 20 mg IV. Alternataive to Thymoglobulin (check with surgeon).
We may give Thymoglobulin OR Simulect OR no “induction antibody.”
4. Heparin IV – check with surgeon for dose during the case.
5. Lasix 40 mg IV (x2 doses): just prior to reperfusion and second dose
10-15 minutes after kidney reperfusion.
6. Mannitol 12.5 mg IV (x2 doses): with Lasix (for kidney transplants).