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General Anesthesia for the Patient with End-Stage Liver Disease and Post Liver Transplantation

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Anesthesia and Perioperative Care for Organ Transplantation

Abstract

Medical advances over the last decades have led to a growing patient population with end-stage liver disease and transplanted livers. These patients might present for elective or emergency surgery. In these patients several aspects need to be considered in order to provide safe anesthesia. This chapter focuses on the preoperative and intraoperative anesthetic management of patients with end-stage liver disease or after liver transplantation subjected to nontransplant surgery. Liver dysfunction, liver disease related organ malfunctions, laboratory testing, immunosuppression, and many other issues are set in context to the choice of anesthetics, intraoperative monitoring, and postoperative care. With a careful evaluation of the physiological and pharmacological specifications of the transplanted liver, the side effects of immunosuppression, the risk of infection, and potential graft dysfunction, general anesthesia can be carried out without compromising the dysfunctional or transplanted liver during nontransplant surgery.

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Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care Medicine, University Medical Center Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany

    Alexander Hoetzel M.D., M.A.

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  1. Alexander Hoetzel M.D., M.A.
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Correspondence to Alexander Hoetzel M.D., M.A. .

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  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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Hoetzel, A. (2017). General Anesthesia for the Patient with End-Stage Liver Disease and Post Liver Transplantation. 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_31

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  • DOI: https://doi.org/10.1007/978-1-4939-6377-5_31

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