Issues in Pediatric Liver Transplantation

Abstract

The chapter highlights current challenges in the perianesthetic care of children presenting for liver transplantation. Pediatric liver transplantation is a lifesaving intervention for children with various congenital or acquired acute and chronic liver diseases. The relatively low number of liver transplantations in the pediatric population nationwide presents a challenge to developing and maintaining sufficient knowledge and skills that are mandatory for the successful anesthetic care of these most critically ill patients. The essential information presented can be utilized to facilitate standardization of practice in any institution performing liver transplantation. The details of perianesthetic management include patient evaluation, comorbidities, monitoring requirements, therapeutic interventions, and postoperative care. The intraoperative period consisting of the preanhepatic, anhepatic, and neohepatic stages are each distinct in their anesthetic management. The clinical challenges encountered in liver transplantation demands an in-depth understanding of the unique physiology in order to avoid and appropriately treat any abnormalities that occur during a successful liver transplant.