Abstract
Liver transplantation (LT) has the potential to cure patients with acute and chronic
liver failure as well as a number of hepatic and biliary malignancies. Over time,
due to the increasing demand for organs as well as improvements in the survival of
LT recipients, patients awaiting LT have become sicker, and often undergo the procedure
while critically ill. This trend has made the process of preoperative assessment and
planning, intraoperative management, and postoperative management even more crucial
to the success of LT programs. Multidisciplinary and specialized teams are essential
and include anesthesiologists, surgeons, and intensivists. This article focuses on
the preoperative evaluation, intraoperative care, and postoperative management of
the liver transplant patient. Management relevant to the critically ill patient is
discussed, with a focus on the management of postoperative cardiopulmonary conditions
including the care of special populations such as those with hepatopulmonary syndrome
and portopulmonary hypertension.
Keywords
liver transplantation - anesthesia - end-stage liver disease - postoperative critical
care - hepatopulmonary syndrome - portopulmonary hypertension
