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Multiorgan Transplantation Including the Liver

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Anesthesia and Perioperative Care for Organ Transplantation

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Abstract

Multiorgan transplantation represents the pinnacle of clinical solid-organ transplantation. Successful outcomes depend on a clear understanding of the indications for transplantation, discriminating candidate selection, meticulous preparation, and constant communication among all involved parties as to operative technique and posttransplant care.

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References

  1. United Network for Organ Sharing: Scientific Registry of Transplant Recipients. http://www.srtr.org. Accessed 1 Apr 2014.

  2. Kamath P, Wiesner R, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33:464–70.

    Article  CAS  PubMed  Google Scholar 

  3. Papafragkakis H, Martin P, Akalin E. Combined liver and kidney transplantation. Curr Opin Organ Transplant. 2010;15:263–8.

    Article  PubMed  Google Scholar 

  4. Eason J, Gonwa T, Davis C, Sung R, Gerber D, Bloom R. Proceedings of Consensus Conference on Simultaneous Liver Kidney Transplantation (SLK). Am J Transplant. 2008;8:2243–51.

    Article  CAS  PubMed  Google Scholar 

  5. Northup P, Argo C, Bakhru M, Schmitt T, Berg C. Pretransplant predictors of recovery of renal function after liver transplantation. Liver Transpl. 2010;16:440–6.

    PubMed  Google Scholar 

  6. Charlton M, Wall W, Ojo A, et al. Report of the First International Liver Transplantation Society Expert Panel Consensus Conference on Renal Insufficiency in Liver Transplantation. Liver Transpl. 2009;15:S1–34.

    Article  PubMed  Google Scholar 

  7. Davis C, Feng S, Sung R, et al. Simultaneous liver-kidney transplantation: evaluation to decision making. Am J Transplant. 2007;7:1702–9.

    Article  CAS  PubMed  Google Scholar 

  8. Bahirwani R, Campbell M, Siropaides T, et al. Transplantation: impact of pretransplant renal insufficiency. Liver Transpl. 2008;14:665–71.

    Article  PubMed  Google Scholar 

  9. Ojo A, Held P, Port F, et al. Chronic renal failure after transplantation of a nonrenal organ. N Engl J Med. 2003;349:931–40.

    Article  CAS  PubMed  Google Scholar 

  10. Fong T, Khemichian S, Shah T, Hutchinson I, Cho Y. Combined liver-kidney transplantation is preferable to liver transplant alone for cirrhotic patients with renal failure. Transplantation. 2012;94:411–6.

    Article  CAS  PubMed  Google Scholar 

  11. Naravanan Menon K, Nyberg S, Harmsen W, et al. MELD and other factors associated with survival after liver transplantation. Am J Transplant. 2004;4:819–25.

    Article  Google Scholar 

  12. Diaz G. Combined solid organ transplantation involving the liver. In: Wagener G, editor. Liver anesthesiology and critical care medicine. New York, NY: Springer; 2012. p. 205–14.

    Chapter  Google Scholar 

  13. Douthitt L, Bezinover D, Uemura T, et al. Perioperative use of continuous renal replacement therapy for orthotopic liver transplantation. Transplant Proc. 2012;44:1314–7.

    Article  CAS  PubMed  Google Scholar 

  14. Townsend D, Bagshaw S, Jacka M, Bigam D, Cave D, Gibney R. Intraoperative renal support during liver transplantation. Liver Transpl. 2009;15:73–8.

    Article  PubMed  Google Scholar 

  15. Spiro M, Eilers H. Intraoperative care of the transplant patient. Anesthesiol Clin. 2013;31:705–21.

    Article  PubMed  Google Scholar 

  16. Lee E, Kang J, Yun S, et al. Risk factors for central pontine and extrapontine myelinolysis following orthotopic liver transplantation. Eur Neurol. 2009;62:362–8.

    Article  PubMed  Google Scholar 

  17. Davidson I. Renal impact of fluid management with colloids: a comparative review. Eur J Anesthesiol. 2006;23:721–38.

    Article  CAS  Google Scholar 

  18. Diaz G, Wagener G, Renz J. Postoperative care/critical care of the transplant patient. Anesthesiol Clin. 2013;31:723–35.

    Article  PubMed  Google Scholar 

  19. Starzl T, Bahnson H, Hardesty R, et al. Heart-liver transplantation in a patient with familial hypercholesterolaemia. Lancet. 1984;323:1382–3.

    Article  Google Scholar 

  20. Te H, Anderson A, Millis J, Jeevanandam V, Jensen D. Current state of combined heart-liver transplantation in the United States. J Heart Lung Transplant. 2008;27:753–9.

    Article  PubMed  Google Scholar 

  21. Raichlin E, Daly R, Rosen C, et al. Combined heart and liver transplantation: a single-center experience. Transplantation. 2009;88:219–25.

    Article  PubMed  Google Scholar 

  22. Hennessey T, Backman S, Cecere R, et al. Combined heart and liver transplantation on cardiopulmonary bypass: report of four cases. Can J Anesth. 2010;57:355–60.

    Article  PubMed  Google Scholar 

  23. Nagpal A, Chamogeorgakis T, Shafii A, et al. Combined heart and liver transplantation: the Cleveland Clinic experience. Ann Thorac Surg. 2013;95:179–82.

    Article  PubMed  Google Scholar 

  24. Porrett P, Desai S, Timmins K, Twomey C, Sonnad S, Olthoff K. Combined orthotopic heart and liver transplantation: the need for exception status listing. Liver Transpl. 2004;10:1539–44.

    Article  PubMed  Google Scholar 

  25. Schaffer J, Chiu P, Singh S, Oyer P, Reitz B, Mallidi H. Combined heart-liver transplantation in the MELD era: do waitlisted patients require exception status? Am J Transplant. 2014;14:647–59.

    Article  CAS  PubMed  Google Scholar 

  26. Natale M, Piña IL. Evaluation of pulmonary hypertension in heart transplant recipients. Curr Opin Cardiol. 2003;18:136–40.

    Article  PubMed  Google Scholar 

  27. Diaz G, Renz J, Nishanian E, Kinkhabwala M, Emond J, Wagener G. Anesthetic management of combined heart-liver transplantation. J Cardiothorac Vasc Anesth. 2007;21:253–6.

    Article  PubMed  Google Scholar 

  28. Iwakiri Y, Groszmann R. The hyperdynamic circulation of chronic liver diseases: from the patient to the molecule. Hepatology. 2006;43:S121–31.

    Article  CAS  PubMed  Google Scholar 

  29. Offstad J, Schrumpf E, Geiran O, Soreide O, Simonsen S. Plasma exchange and heart-liver transplantation in a patient with homozygous familial hypercholesterolemia. Clin Transplant. 2001;15:432–6.

    Article  CAS  PubMed  Google Scholar 

  30. Pirenne J, Verleden G, Nevens F, et al. Combined liver and (heart-) lung transplantation in liver transplant candidates with refractory portopulmonary hypertension. Transplantation. 2002;73:140–56.

    Article  PubMed  Google Scholar 

  31. Nussmeier N, Hauser M, Sarwar M, Grigore A, Searles B. Anesthesia for cardiac surgical procedures. In: Miller R, editor. Miller’s anesthesia. 7th ed. Philadelphia, PA: Churchill Livingstone; 2009. p. 1889–975.

    Google Scholar 

  32. Detry O, Honore P, Meurisse M. Advantages of inferior vena caval flow preservation in combined transplantation of the liver and heart. Transpl Int. 1997;10:150–1.

    Article  CAS  PubMed  Google Scholar 

  33. Tripodi A, Mannucci P. The coagulopathy of chronic liver disease. N Engl J Med. 2011;365:147–56.

    Article  CAS  PubMed  Google Scholar 

  34. Cheng D, Ong D. Anaesthesia for non-cardiac surgery in heart-transplanted patients. Can J Anesth. 1993;40:981–6.

    Article  CAS  PubMed  Google Scholar 

  35. Rossi G. Veno-venous bypass versus no bypass in orthotopic liver transplantation: hemodynamic, metabolic, and renal data. Transplant Proc. 1998;30:1871–3.

    Article  CAS  PubMed  Google Scholar 

  36. Belghiti J, Ettore G, Durand F, et al. Feasibility and limits of caval-flow preservation during liver transplantation. Liver Transpl. 2001;7:983–7.

    Article  CAS  PubMed  Google Scholar 

  37. Ozier Y, Klinck J. Anesthetic management of hepatic transplantation. Curr Opin Anesthesiol. 2008;21:391–400.

    Article  Google Scholar 

  38. Fitzsimons M, Ichinose F, Vagefi P, et al. Successful right ventricular mechanical support after combined heart-liver transplantation. J Cardiothorac Vasc Anesth. 2014;28(6):1583–5.

    Article  PubMed  Google Scholar 

  39. Chuttani K, Tischler M, Pandian N, Lee R, Mohanty P. Diagnosis of cardiac tamponade after cardiac surgery: relative value of clinical, echocardiographic, and hemodynamic signs. Am Heart J. 1994;127:913–8.

    Article  CAS  PubMed  Google Scholar 

  40. Barshes N, DiBardino D, McKenzie E, et al. Combined lung and liver transplantation: the United States experience. Clin Transplant. 2005;80:1161–7.

    Article  Google Scholar 

  41. Egan T, Murray S, Bustami R, et al. Development of the new lung allocation system in the United States. Am J Transplant. 2006;6:1212–27.

    Article  CAS  PubMed  Google Scholar 

  42. Yi S, Burroughs S, Loebe M, et al. Combined lung and liver transplantation: analysis of a single-center experience. Liver Transpl. 2014;20:46–53.

    Article  PubMed  Google Scholar 

  43. Scouras N, Matsusaki T, Boucek C, et al. Portopulmonary hypertension as an indication for combined heart, lung, and liver or lung and liver transplantation: literature review and case presentation. Liver Transpl. 2011;17:137–43.

    Article  PubMed  Google Scholar 

  44. Couetil J, Houssin D, Soubrane O, et al. Combined lung and liver transplantation in patients with cystic fibrosis: a 4 1/2-year experience. J Thorac Cardiovasc Surg. 1995;110:1415–23.

    Article  CAS  PubMed  Google Scholar 

  45. Zimmerman A, Howard T, Huddleston C. Combined lung and liver transplantation in a girl with cystic fibrosis. Can J Anesth. 1999;46:571–5.

    Article  CAS  PubMed  Google Scholar 

  46. Grannas G, Neipp M, Hoeper M, et al. Indications for and outcomes after combined lung and liver transplantation: a single-center experience on 13 consecutive cases. Transplantation. 2008;85:524–31.

    Article  PubMed  Google Scholar 

  47. Arnon R, Annunziato R, Miloh T, et al. Liver and combined lung and liver transplantation for cystic fibrosis: analysis of the UNOS database. Pediatr Transplant. 2011;15:254–64.

    Article  PubMed  Google Scholar 

  48. Arcasoy S, Kotloff R. Lung transplantation. N Engl J Med. 1999;340:1081–91.

    Article  CAS  PubMed  Google Scholar 

  49. Wallwork J, Williams R, Calne R. Transplantation of liver, heart, and lungs for primary biliary cirrhosis and primary pulmonary hypertension. Lancet. 1987;25:182–5.

    Article  Google Scholar 

  50. Marczin N, Royston D, Yacoub M. Pro: Lung transplantation should be routinely performed with cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2000;14:739–45.

    Article  CAS  PubMed  Google Scholar 

  51. Diaz G, Renz J. Cardiac surgery in patients with end-stage liver disease. J Cardiothorac Vasc Anesth. 2014;28:155–62.

    Article  PubMed  Google Scholar 

  52. Suzuki Y, Cantu E, Christie J. Primary graft dysfunction. Semin Respir Crit Care Med. 2013;34:305–19.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Flynn B, Hastie J, Sladen R. Heart and lung transplantation. Curr Opin Anesthesiol. 2014;27:153–60.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Anesthesia and Critical Care, University of Chicago, 5841 S. Maryland Ave., Chicago, IL, 60637, USA

    Geraldine C. Diaz D.O.

  2. Department of Surgery, University of Chicago, 5841 S. Maryland Ave., Chicago, IL, 60637, USA

    John F. Renz M.D., Ph.D.

Authors
  1. Geraldine C. Diaz D.O.
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  2. John F. Renz M.D., Ph.D.
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Corresponding author

Correspondence to Geraldine C. Diaz D.O. .

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

    Kathirvel Subramaniam

  2. Department of Anesthesiology The Clinical and Translational Science Institute The McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

    Tetsuro Sakai

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Diaz, G.C., Renz, J.F. (2017). Multiorgan Transplantation Including the Liver. In: Subramaniam, K., Sakai, T. (eds) Anesthesia and Perioperative Care for Organ Transplantation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6377-5_30

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  • DOI: https://doi.org/10.1007/978-1-4939-6377-5_30

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-6375-1

  • Online ISBN: 978-1-4939-6377-5

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