Perioperative anesthetic management for recipients of orthotopic liver transplant undergoing nontransplant surgery.
OBJECTIVE
The number of organ transplant recipients who present for nontransplant surgery has increased annually. The aim of this study was to evaluate the perioperative anesthetic management of recipients of an orthotopic liver transplant who have undergone nontransplant surgery at Baskent University Hospital.


METHODS
The medical records of 22 recipients of an orthotopic liver transplant who had undergone a total of 32 nontransplant elective surgeries between December 1988 and February 2006 were retrospectively reviewed. Demographic information, including the anesthetic management and the results of perioperative liver and renal function tests, was recorded.


RESULTS
The mean age of the patients at the time of transplant was 20.2 +/- 17.9 years. The mean interval from liver transplant to the first surgery was 739.1 +/- 502.2 days. The most frequent type of surgery was abdominal (28.1%). The types of anesthetic techniques used were general (75%), regional (9.4%), local (9.4%), and sedoanalgesia (6.3%). General anesthesia was induced with thiopental, propofol, or ketamine, and was maintained with isoflurane and nitrous oxide. Endotracheal intubation was performed in 43.8% of the patients. Spinal anesthesia was induced in 3 patients, and peripheral neural blockage was used in 2 patients. Prothrombin time, activated partial thromboplastin time, international normalized ratio, and levels of serum alanine transaminase, aspartate transaminase, total bilirubin, blood urea nitrogen, and creatinine were similar preoperatively and on the first day after surgery (P > .05).


CONCLUSIONS
In this study, neither regional nor general anesthesia was associated with a deterioration of liver function. We suggest that recipients of orthotopic liver transplant can undergo nontransplant surgery without postoperative graft dysfunction if hepatic perfusion is maintained with appropriate anesthetic management.
Zeyneloglu
Pinar
P
Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey.
Pirat
Arash
A
Sulemanji
Demet
D
Torgay
Adnan
A
Karakayali
Hamdi
H
Arslan
Gulnaz
G
D000328:Adult; D000758:Anesthesia / Q000379:methods*; D005260:Female; D006801:Humans; D007668:Kidney / Q000502:physiology; D008099:Liver / Q000502:physiology; D016031:Liver Transplantation; D008297:Male; D010477:Perfusion; D019990:Perioperative Care / Q000379:methods; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods