title: Criteria for immediate postoperative extubation in adult recipients following living-related liver transplantation with total intravenous anesthesia.
abstract: OBJECTIVE
  To evaluate whether our criteria for immediate postoperative extubation predicts successful extubation in living-related liver transplantation of the right lobe, and to test the effects of our standardized anesthetic technique on the success of immediate postoperative extubation.
  
  
  METHODS
  Open-label, descriptive study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  6 ASA physical status III and IV patients with end-stage liver disease undergoing living-related liver transplantation of the right lobe.
  
  
  METHODS
  Patients received a standardized anesthetic technique with propofol, remifentanil, and cisatracurium. They were extubated when they met our criteria for immediate postoperative extubation: good donor liver function, <10 U packed red blood cells administered, hemodynamic stability, and alveolar-arterial oxygen gradient <200 mmHg.
  
  
  RESULTS
  At the end of surgery, four of the six patients fulfilled our criteria for immediate postoperative extubation. They were uneventfully extubated rapidly after surgery and soon arrived in the intensive care unit. Their postoperative stay in the operating room was only 36 minutes (range: 30 to 42 min). No patient required reintubation in the operating room or the intensive care unit. They had no recorded hemodynamic or respiratory problems postoperatively.
  
  
  CONCLUSIONS
  Immediate extubation of selected living-related liver transplant recipients can be a safe procedure. Anesthetic management to immediate extubation seems appropriate and the derived guidelines appear acceptable.
authors.affiliation: Department of Anesthesia, Critical Care Medicine and Department of Surgery, Ghent University Hospital, Ghent, Belgium. Guy.Cammu@olvz-aalst.be
authors.forename: Guy
authors.initials: G
authors.lastname: Cammu
authors.forename: Johan
authors.initials: J
authors.lastname: Decruyenaere
authors.forename: Roberto
authors.initials: R
authors.lastname: Troisi
authors.forename: Bernard
authors.initials: B
authors.lastname: de Hemptinne
authors.forename: Francis
authors.initials: F
authors.lastname: Colardyn
authors.forename: Eric
authors.initials: E
authors.lastname: Mortier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous; D004906:Erythrocyte Count; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007442:Intubation, Intratracheal; D008107:Liver Diseases / Q000601:surgery; D008111:Liver Function Tests; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011184:Postoperative Period