Is there any difference in anesthetic management of different post-OLT stage patients undergoing nontransplant organ surgery?
BACKGROUND
Little information is available about anesthesia management of nontransplant organ surgery of recipients after adult liver transplantation. The aim of this study was to discuss the anesthesia management of recipients for different stages after liver transplantation.


METHODS
The medical records of 16 patients were reviewed after OLT scheduled for elective nontransplant organ surgery at our institution from September 2002 to October 2005. The patients were divided into perioperative stage (group A) and mid-term and long-term stage (group B) groups according to post-OLT time. The data of 16 patients preoperation, intraoperation and postoperation were analyzed.


RESULTS
The measurements of alanine transaminase (ALT), total bilirubin (TB), prothrombin time (PT), and lung infection were significantly higher in group A than in group B (P<0.05). The incidence of hyperglycaemia was significantly higher in group B than in group A (P<0.05). During operation the incidence of hypotension was significantly higher in group A than in group B (P<0.05). After operation, the number of patients in ICU was significantly larger and the extubation time was longer in group A than in group B. General anesthesia was induced in 14 patients, and regional anesthesia in 2 patients.


CONCLUSIONS
Regional or general anesthesia can be safely delivered to adult OLT recipients except for contraindications. Special considerations include protection of the function of important organs, correction of hemodynamic instability in perioperative stage patients after OLT, and measurement of the side-effects of immunosuppression in mid-term and long-term stage patients.
Feng
Zhi-Ying
ZY
Department of Anesthesiology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Zhang
Jian
J
Zhu
Sheng-Mei
SM
Zheng
Shu-Sen
SS
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016528:Postanesthesia Nursing; D011517:Prothrombin Time
D000410:Alanine Transaminase; D001663:Bilirubin