Anesthesia in liver transplantation

Abstract

Even in centers performing huge numbers of liver transplantation great shifts during the operation is a challenge for the anesthesist. Success of anesthetic management depends on the complete knowledge of physiopathological alterations of the liver disease. Liver transplantation consists of preanhepatic, anhepatic and neohepatic phases. The main problems are massive blood and blood products transfusion, monitorization, prevention and treatment of biochemical and hemodynamic fluctuations according to the phases characteristics. Especially neohepatic phase is very important when acidosis, hyperpotasemia, hypothermia and cardiovascular depression are great problems. The success in this long and hard work depends on full monitorization, and qualified support by the laboratory and blood bank teams. Intensive care management must be performed for these patients.