Anesthetic experience in adult and pediatric orthotopic liver transplantation.
The authors report their experience with orthotopic liver transplantation in 8 adults and 6 children operated during a 14 months period. The anesthetic technique is described and three points of it are underlined: Renal failure is prevented by a systematic low-dose dopamine infusion added to optimal preloading and mannitol given during the anhepatic phase. Donor liver flush via the portal vein with lactated Ringer's solution is checked by serial measurements of K+ concentration in the fluid draining from the infrahepatic vena cava: the flush is assumed adequate if that K+ level is less than 10 mmoles/l. The risk of air embolism at the time of unclamping is minimized by discontinuing N2O, adding a mild PEEP and placing the patient in Trendelenburg position. The values of hemodynamic and metabolic measurements are given and discussed. There was no peroperative mortality.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000768:Anesthesia, General / Q000379:methods; D001786:Blood Glucose / Q000378:metabolism; D001803:Blood Transfusion; D002648:Child; D004231:Diuresis; D006439:Hemodynamics; D006488:Hemostasis, Surgical; D006801:Humans; D007430:Intraoperative Care; D007773:Lactates / Q000097:blood; D016031:Liver Transplantation; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011188:Potassium / Q000097:blood
D001786:Blood Glucose; D007773:Lactates; D011188:Potassium