Clinical Case Database / Category: Case Based Discussion

Peri-operative management of cadaver renal transplant

Publication details

R W S Chang, BSc MS FRCS
Foundation Years Journal, volume 1, issue 3, p.135 (123Doc Education, London, June 2007)


A 56-years-old Caucasian male weighing 87 kg was admitted to the Transplant Unit for a cadaver kidney transplant. He has been on haemodialysis for the past 14 months. The results of his cardiac screening tests were satisfactory and are all in date (within the past 18 months). He last had haemodialysis 2 days ago. There was no recent history or symptoms suggestive of new onset cardiac co-morbidity. On examination his chest was clear and he had no ankle swellings. He had raised internal jugular venous pulse, but was otherwise well. ECG showed mild left ventricular strain. It is important to check that by the scheduled starting time of surgery, the patient would have fasted for more than 4 hours.

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R W S Chang, BSc MS FRCS

Director of Transplantation
St George’s Hospital


1.  Wolfe RA, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation an recipients of a first cavaderic transplant. New EJ Med 1999; 341: 1725-1730.

2.  Kasiske BL, Maclean R, Snyder JJ. Acute myocardial infarction and kidney transplantation. J Am Soc Nephrol 2006; 17:900-907.

3.  Tennant R, Wiggers C. The effect of coronary occlusion on myocardial contraction. Am J Physiol 1935; 112:351–361.


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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