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Transplant Anesthesia

Dartmouth-Hitchcock Medical Center offers comprehensive care of patients undergoing renal and pancreatic transplantation (with living or deceased donor organs). Kidney with transplantation remains the cornerstone of transplant services provided. Living donor kidney transplants may be related or unrelated to the recipients. DHMC also offers live donor paired exchange whereby two or more, incompatible donor/recipient pairs are matched up with each other in order to make two, or more, compatible donor/recipient pairs. Deceased donor renal transplants are obtained from donors who meet either brain death criteria or criteria for cardiopulmonary death (donation after cardiac death).

Patients with Type I diabetes mellitus are potential candidates for pancreas transplantation at DHMC. Pancreas transplantation may occur in the settings of simultaneous pancreas and kidney transplantation (SPK), pancreas transplant after kidney transplant (PAK), or solitary pancreas transplantation.

Patient Care

There have been several advances over the past years in transplant anesthesia at DHMC. First, cardiac assessment for renal transplant patients has been reviewed and revised by Dr. Salvatore Costa in Cardiology. This revised set of guidelines aims at maximizing pre-operative patient evaluation in a cost-effective manner for patients undergoing kidney transplant. Also, the transplant anesthesia team now directly communicates with Dr. Neil Gleason in Anesthesiology to arrange anesthesia preoperative assessment of the most medically complicated patients. Dr. Richard Freeman, Chairman of the Department of Surgery, has lauded the additions and believes that this combination is allowing more complex transplant candidates to receive transplant.

Education

Although we do not have a defined resident rotation in transplantation anesthesia at DHMC, our residents do participate in the perioperative care and management of patients with end-stage kidney and pancreatic disease. During their experience, residents are taught about the complexity of transplant recipient’s physiology both before and after organ transplantation.

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