ANESTHESIOLOGY FAST REVIEW

ANESTHESIOLOGY_FAST_REVIEWKAPAK1-0-25

RENAL AND LIVER TRANSPLANTATION ANESTHESIA

Behiç Girgin

Ankara Bilkent City Hospital, Department of Anesthesiology and Reanimation, Ankara, Türkiye

Girgin B. Renal and Liver Transplantation Anesthesi. In: Kazancı D, editor. Anesthesiology Fast Review. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.403-417.

ABSTRACT

Anesthesia Management in Kidney and Liver Transplantation Renal and Liver Transplantation Anesthesia underscores the vital role of anesthesiologists in facilitating successful organ transplantation. This chapter offers an evidence-based framework for anesthetic management during liver and kidney transplants, highlighting key aspects such as preoperative preparation, intraoperative techniques and postoperative care protocols.

  • Importance of Transplantation: Liver and kidney transplantation are life-saving interventions for end-stage organ failure, improving survival and quality of life.
  • Liver Transplantation: Effective anesthetic management ensures hemodynamic stability, reduces complications like post reperfusion syndrome and promotes long-term recovery.
  • Kidney Transplantation: Anesthetic strategies focus on managing metabolic disturbances and cardiovascular stability, essential for graft function and patient outcomes.
  • Anesthesiologist’s Role: Preoperative assessments, intraoperative monitoring (such as advanced hemodynamic monitoring) and postoperative recovery plans are critical. Techniques like transesophageal echocardiography and enhanced recovery protocols improve surgical outcomes.
  • Preoperative Preparation: Includes medical optimization for liver and kidney transplant candidates, such as cardiovascular and renal function assessments and nutritional support.
  • Intraoperative Management: Divided into pre-anhepatic, anhepatic, and neo-hepatic phases in liver transplantation, with monitoring techniques like advanced hemodynamic monitors and thromboelastography. Kidney transplantation emphasizes fluid balance and hemodynamic control.
  • Postoperative Care: Focuses on hemodynamic monitoring, pain management with multimodal analgesia, and immunosuppression protocols to prevent rejection while minimizing complications.

Keywords: Kidney transplantation; Liver transplantation; Hemodynamic monitoring; Blood coagulation factors; Blood gas analysis

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