An overview of unresolved issues in the perioperative management of liver transplant patients

Saurabh Mittal; Medha Bhardwaj; Praveenkumar Shekhrajka; Vipin Kumar Goyal; Ganesh Ramaji Nimje; Sakshi Kanoji; Suma Katyaeni Danduri; Anshul Vishnoi

doi:10.4285/kjt.23.0061

View

Article

View

Korean J Transplant 2023; 37(4): 221-228

Published online December 31, 2023

https://doi.org/10.4285/kjt.23.0061

An overview of unresolved issues in the perioperative management of liver transplant patients

Saurabh Mittal¹, Medha Bhardwaj², Praveenkumar Shekhrajka³, Vipin Kumar Goyal¹, Ganesh Ramaji Nimje¹, Sakshi Kanoji¹, Suma Katyaeni Danduri¹, Anshul Vishnoi¹

¹Department of Organ Transplant Anaesthesiology and Critical Care, Mahatma Gandhi Medical College and Hospital, Jaipur, India
²Department of Neuro-Anaesthesia, Mahatma Gandhi Medical College and Hospital, Jaipur, India
³Department of Anaesthesia, Mahatma Gandhi Medical College and Hospital, Jaipur, India

Correspondence to: Vipin Kumar Goyal
Department of Organ Transplant Anaesthesiology and Critical Care, Mahatma Gandhi Medical College and Hospital, Sitapura, Jaipur 302022, India
E-mail: dr.vipin28@gmail.com

Received: October 26, 2023; Revised: November 20, 2023; Accepted: November 21, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Go to
Abstract

Over the past decade, the field of solid organ transplantation has undergone significant changes, with some of the most notable advancements occurring in liver transplantation. Recent years have seen substantial progress in preoperative patient optimization protocols, anesthesia monitoring, coagulation management, and fluid management, among other areas. These improvements have led to excellent perioperative outcomes for all surgical patients, including those undergoing liver transplantation. In the last few decades, there have been numerous publications in the field of liver transplantation, but controversies related to perioperative management of liver transplant recipients persist. In this review article, we address the unresolved issues surrounding the anesthetic management of patients scheduled for liver transplantation.

Keywords: Coronary artery disease, End-stage liver disease, Intracranial pressure, Liver transplantation, Pulmonary hypertension

HIGHLIGHTS

In recent years, significant advancements have been made in preoperative patient optimization protocols, anesthesia monitoring, coagulation management, and fluid management.
These improvements have led to excellent perioperative outcomes for all surgical patients, including those undergoing liver transplantation.
Some unresolved issues still exist regarding perioperative anesthesia in patients during liver transplantation.