Continuous spinal anaesthesia for kidney transplantation in a lupus patient with severe mitral regurgitation: A case...

Anaesthesia for kidney transplant in a patient with severe mitral regurgitation is a real challenge given the need for judicious haemodynamic management to avoid pulmonary oedema and maximise reperfusion of the transplanted organ. This is the first experience described in the literature of continuous spinal anaesthesia in a patient with chronic severe mitral regurgitation undergoing cadaver donor kidney transplant. Transthoracic echocardiography monitoring was used during the procedure to avoid aggravating the patient's mitral regurgitation. Intraoperatively, 17.5 ml/kg of crystalloids were administered and no vasopressors were required. Continuous spinal anaesthesia preserved haemodynamics and graft perfusion during the procedure.