Perioperative Anesthetic Management of Patients Having Liver Transplantation for Uncommon Conditions

Semin Cardiothorac Vasc Anesth. 2018 Jun;22(2):197-210. doi: 10.1177/1089253217732129. Epub 2017 Sep 18.

Abstract

This review focuses on the perioperative anesthetic management of patients having liver transplantation (LT) performed for several uncommon indications or in combination with rare pathology. Conditions discussed in the article include Alagille syndrome, hypertrophic cardiomyopathy, Gilbert's syndrome, porphyria, Wilson's disease, and Budd-Chiari syndrome. In comparison to other indications, LT in these settings is infrequent because of the low incidence of these pathologies. Most of these conditions (with the exception of Gilbert syndrome) are associated with a high probability of significant perioperative complications and increased mortality and morbidity. Experience in management of these unusual conditions is only gained over time. Developing clinical pathways for patients with these conditions should result in outcomes similar to LT performed for more common indications.

Keywords: liver transplantation; perioperative management; uncommon conditions.

Publication types

  • Review

MeSH terms

  • Alagille Syndrome / surgery
  • Anesthetics / pharmacology*
  • Cardiomyopathy, Hypertrophic / surgery
  • Gilbert Disease / surgery
  • Humans
  • Liver Transplantation*
  • Perioperative Care*
  • Porphyria, Acute Intermittent / surgery
  • Postoperative Care
  • Protoporphyria, Erythropoietic / surgery

Substances

  • Anesthetics