Hemodynamic monitoring in pigs undergoing orthotopic abdominal multivisceral transplantation.
Anesthesia for abdominal multivisceral transplantation (MVTx) is challenging. Surgical success depends on hemodynamic stability throughout organ removal from the donor and engraftment in recipients. The aim of the current study was to summarize our experience with anesthetic management including monitoring of hemodynamic changes in pigs during MVTx procedures.


METHODS
Ten male pigs were randomly divided into two groups: donors and recipients for five MVTxs. A pulmonary artery catheter (PAC), transesophageal echocardiography (TEE), and pulse indicator continuous cardiac output (PiCCO) were used intraoperatively in recipients to monitor hemodynamic changes.


RESULTS
Two recipients had cardiac arrest and died intraoperatively presumably due to hypovolemia. The data obtained by PAC and TEE from three successful cases showed huge changes in hemodynamics during the stages of organ removal and reperfusion after engraftment. Use of PiCOO in one of those three cases allowed successful fluid management, resulting in stable intraoperative hemodynamics.


CONCLUSIONS
The anesthetic management for MVTx surgery was improved by PAC, TEE, and PiCOO monitoring.
Gu
J
J
Department of Anaesthesiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Tao
G
G
Yi
B
B
Liu
D
D
Guo
Y
Y
Wang
H
H
Lu
K
K
D000005:Abdomen; D000818:Animals; D001794:Blood Pressure; D002404:Catheterization; D002496:Central Venous Pressure; D017548:Echocardiography, Transesophageal; D004784:Environmental Monitoring / Q000379:methods; D006439:Hemodynamics; D008297:Male; D011651:Pulmonary Artery; D013552:Swine; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000379:methods; D016277:Ventricular Function, Left / Q000502:physiology; D014781:Viscera / Q000637:transplantation*