An Outpatient Hospital-based Exercise Training Program for Patients With Cirrhotic Liver Disease Awaiting Transplantation: A Feasibility Trial.

Background: Time spent on the waiting list before liver transplantation (LT) provides an opportunity to optimize recipient fitness through prehabilitation, potentially reducing the physiological impact of major surgery. We assessed the feasibility and effectiveness of a 6-week exercise program in patients with cirrhotic liver disease awaiting LT.

Methods: This single-center, prospective cohort, feasibility study, enrolled patients awaiting LT to a 6-week period of thrice weekly, supervised exercise on a static bike.

Anaesthesia for liver transplantation.

Liver transplantation is a complex procedure that requires a truly multidisciplinary team approach with anaesthetic involvement from the outset in order to ensure excellent outcomes. Before a patient is placed on the waiting list for a liver transplant, a thorough evaluation is undertaken and his/her suitability for transplantation discussed in a patient selection committee meeting. The perioperative management of patients requiring transplantation can be challenging because of the systemic implications of liver disease, approaches to surgical technique and the quality of the grafts used; an increase in the use of marginal donor organs to meet the organ demand poses its own unique difficulties.

Thromboelastography-guided recombinant factor VIIa administration in a patient with refractory autoimmune idiopathic thrombocytopenia.

Autoimmune idiopathic thrombocytopenia poses a significant challenge for clinicians in the perioperative period. Repeat platelet transfusions may not result in satisfactory increments in the platelet count and routine coagulation screens may not reflect the degree of abnormal hemostasis. We report the use of point-of-care testing with thromboelastography and platelet counting in managing a patient with refractory autoimmune idiopathic thrombocytopenia, undergoing a splenectomy for active bleeding.