🏥[Case Review] Simultaneous Liver-Kidney TPL 🫀Anesthesia Management 💉 | feat. Hepatorenal Sx.🫁

Описание: 📌 Simultaneous Liver–Kidney Transplantation (SLKT/CLKT) represents one of the most complex procedures in modern transplantation medicine.
This video provides a comprehensive, anesthesia-focused review of real clinical cases and evidence-based perioperative guidelines for SLKT.
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🔹 Part 1. Case Presentation – Practical Anesthetic Strategies from Real Cases 🏥
Case 1. ADPKD Kidney & Liver Transplantation
• Combined renal and hepatic involvement in Autosomal Dominant Polycystic Kidney Disease (ADPKD)
• Preoperative assessment: clinical presentation, laboratory findings, liver and renal function, electrolytes, and clinical scoring systems
• Surgical planning and key anesthetic decision-making
• Intraoperative course and management
Case 2. Hepatorenal Syndrome (HRS)
• Clinical background and significance of HRS
• Preoperative patient evaluation
• Anesthetic and monitoring strategies
• Phased fluid and hemodynamic management 💧📈
• Role of intraoperative renal replacement therapy (RRT)
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🔹 Part 2. Clinical Guideline – Core Principles of Anesthetic Management for CLKT 📘
• Rationale and pathophysiologic basis for CLKT
• Hepatorenal Syndrome: comparison of old vs. new diagnostic criteria (table) and explanation of Stages 1–3
• ADPKD-specific considerations: mass effect, vascular complications, and surgical implications
• Key anesthetic pharmacologic considerations in CLKT (table) 💊
• Phase-based intraoperative hemodynamic goals with preload and afterload strategies (table)
• Principles of intraoperative RRT/CRRT and comparison of CRRT modalities ⚙️
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🔹 Part 3. Comprehensive Review – Current Evidence on Adult SLKT 📊
• The rise of SLKT and its evolving clinical landscape
• Etiologies and pathophysiology of concurrent liver and kidney failure
• HRS pathophysiology and comparison of historical vs. updated classifications
• The SLKT vs. liver transplant alone (LTA) dilemma
• OPTN “Safety Net” policy and its clinical implications
• Comparative analysis of patient survival, graft survival, and post-transplant renal outcomes
• Prognostic factors influencing survival in SLKT and dual-listed patients
• Anesthetic considerations and perioperative implications
• Pharmacokinetic impact of anesthetic agents in SLKT (table)
• Strategic role of intraoperative renal replacement therapy (IORRT)
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🎯 This video is intended for
• Anesthesiologists and trainees involved in liver and kidney transplantation
• Clinicians managing patients with advanced hepatic and renal failure
• Healthcare professionals seeking a structured, evidence-based approach to SLKT perioperative management
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