Fast but safe: speeding up clinical pathways in solid organ transplantation. An overview

Area of Science:

• Transplant Anesthesiology
• Perioperative Medicine
• Surgical Outcomes

Background:

• Clinical pathways like fast-track and enhanced recovery after surgery (ERAS) are increasingly used in transplant anesthesiology.
• These protocols standardize evidence-based perioperative interventions to enhance patient outcomes.
• The origins and evolution of these concepts within transplantation are reviewed.

Purpose of the Study:

• To define fast-track and ERAS in transplant anesthesiology.
• To review the application of these pathways in liver, kidney, and thoracic organ transplantation.
• To examine current evidence, recommendations, and future research directions.

Main Methods:

• Expert opinion paper synthesizing current literature.
• Review of evidence and recommendations for fast-track and ERAS in specific transplant areas.
• Identification of opportunities for future research and guideline development.

Main Results:

• Fast-track and ERAS protocols are integral to modern transplant anesthesiology.
• Evidence and recommendations vary across liver, kidney, and thoracic organ transplantation.
• Significant opportunities exist for advancing research and guideline development in this field.

Conclusions:

• Fast-track and ERAS protocols represent a significant advancement in transplant anesthesiology.
• Standardized perioperative care pathways are crucial for optimizing patient outcomes.
• Further research is needed to refine and expand the application of these protocols across all transplant types.