Enhanced recovery after surgery and practical application to liver transplantation
Publication date: Available online 18 February 2020Source: Best Practice &Research Clinical AnaesthesiologyAuthor(s): M. Susan Mandell, Jiapeng Huang, Jing Zhao
Abstract BACKGROUND Our study compared the myocardiac protective effect of propofol vs. sevoflurane in pediatric patients receiving living donor liver transplantation (LDLT) surgery. MATERIAL AND METHODS We randomly and equally divided 120 children who underwent LDLT into a sevoflurane group and a propofol group. Preoperative, intraoperative, and postoperative data were collected and compared between the 2 groups. The concentrations of cTnI, CK-MB, IL-6, TNF-alpha, and HMGB1 at 5 min after induction (T0), 30 min in the anhepatic period (T1), and 3 h after reperfusion (T2), and at the end of surgery (T3) were measu...
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No abstract available
INTRAOPERATIVE transesophageal echocardiography (TEE) is a valuable diagnostic and monitoring tool during liver transplantation (LT).1 Despite concerns about bleeding risk in patients with end-stage liver disease, multiple studies have established the safety and utility of TEE in this patient population.2,3 Although a majority of practicing LT anesthesiologists find intraoperative TEE to be clinically valuable, only a small percentage use it routinely or have obtained certification through the National Board of Echocardiography.
The aim of the present study was to investigate the role of intraoperative oxygen content on the development of early allograft dysfunction (EAD) in patients undergoing living donor liver transplantation (LDLT). This retrospective review included 452 adult patients who underwent elective LDLT. Our study population was classified into 2 groups: EAD and non-EAD. Arterial blood gas analysis was routinely performed 3 times during surgery: during the preanhepatic phase (ie, immediately after anesthetic induction); during the anhepatic phase (ie, at the onset of hepatic venous anastomosis); and during the neohepatic phase (ie, ...
We describe the challenges in managing a 21-month-old female child weighing 7 kg for a combined liver-kidney transplant from two related living donors.
CONCLUSIONS: About 46% of our pediatric orthotopic liver transplant recipients required mechanical ventilation postoperatively. Growth failure and higher intraoperative lactate levels were associated with need for postoperative mechanical ventilation. PMID: 32370697 [PubMed - as supplied by publisher]
AbstractPurposeDonation after circulatory determination of death (DCD) has been performed in Canada since 2006. Numerous aspects of donor management remain controversial.MethodsWe performed a multicentre cohort study involving potential DCD donors in western Canada (2008 –2017), as well as recipients of their organs, to describe donor characteristics and critical care practices, and their relation to one-year recipient and graft survival.ResultsThere were 257 patients in four provinces that underwent withdrawal of life-sustaining therapies (WLST) in anticipation of possible DCD. The proportion of patients that died w...