Objective: The anhepatic phase of orthotopic liver transplantation (OLT) is associated with significant changes in pharmacokinetics. The aim of this study was to compare the influence of this phase on propofol target concentrations during BIS guided target controlled infusion (TCI).
Study Design: Prospective study.
Patients And Methods: Eight patients aged 25 to 65 years, Child-Pugh status A-B scheduled for OLT were prospectively included. Anesthesia was performed using TCI of propofol (Diprifusor, Marsh pharmacokinetic model), sufentanil and cisatracurium. Propofol target concentration was adjusted to maintain BIS values between 40 and 50.
Results: To maintain stable BIS values, propofol target concentrations should be decreased during the anhepatic phase versus the dissection one (2.0 microg/ml+/-0.8 versus 3.0 microg/ml+/-0.9, p<0.0001).
Conclusion: BIS could be useful to titrate propofol infusion during the anhepatic phase of OLT.
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http://dx.doi.org/10.1016/j.annfar.2008.10.005 | DOI Listing |
Anesth Analg
September 2024
From the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona.
Background: During orthotopic liver transplantation, allograft reperfusion is a dynamic point in the operation and often requires vasoactive medications and blood transfusions. Normothermic machine perfusion (NMP) of liver allografts has emerged to increase the number of transplantable organs and may have utility during donation after circulatory death (DCD) liver transplantation in reducing transfusion burden and vasoactive medication requirements.
Methods: This is a single-center retrospective study involving 226 DCD liver transplant recipients who received an allograft transported with NMP (DCD-NMP group) or with static cold storage (DCD-SCS group).
Indian J Anaesth
November 2024
Department of Anaesthesia, Institute of Liver and Biliary Sciences, Delhi, India.
Liver Transpl
December 2024
Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Conventional ischemia-free liver transplantation (CIFLT) represents a pioneering procedure that circumvents ischemia-reperfusion injury to livers throughout the transplant procedure. However, its complexity has limited its widespread adoption. This study introduced a simplified ischemia-free liver transplantation (SIFLT) technique by providing an alternating flow of the portal vein and hepatic artery, demonstrating its efficacy and safety.
View Article and Find Full Text PDFSurg Open Sci
December 2024
Department of Geriatric Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Background: The current method for liver graft implantation during the anhepatic phase is complex. Therefore, this study aimed to introduce a modified orthotopic liver transplantation (OLT) technique with major vascular reconstruction using cuff technique to simplify the process of liver graft implantation during the anhepatic phase.
Methods: Twenty-four canines were randomly assigned to two groups: the modified orthotopic liver transplantation group (M-OLT, = 12) and the control group (n = 12).
Exp Clin Transplant
October 2024
From the Division of Transplantation, Department of General Surgery, Baskent University, Ankara, Turkey.
Objectives: Alagille syndrome is an autosomal recessive disorder with multisystemic involvement. Patients with Alagille syndrome have many accompanying anomalies such as atypical facial appearance, posterior embryotoxon, butterfly vertebra, cardiac anomalies, and biliary problems. Liver and heart complications can determine the mortality and morbidity of patients with Alagille syndrome.
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