Korean J Anesthesiol.  1999 Sep;37(3):419-425. 10.4097/kjae.1999.37.3.419.

Anesthetic Management for Pediatric Living Related Liver Transplantation: Experience of 30 Cases

• Hwang KS
• Choi KT
• Lee YM
• Lee SY
• Park SK
• Lee C

• KMID: 2240042
• DOI: http://doi.org/10.4097/kjae.1999.37.3.419

Abstract

BACKGROUND: Living related liver transplantation (LRLT) was developed to alleviate the mortality resulting from the scarcity of suitable cadevaric grafts. The purpose of this study is to review 30 cases of pediatric living-related liver transplantation, and to find the proper anesthetic management for this operation.
METHODS
We retrospectively analyzed the medical records of 23 cases (body weight < 15 kg) of liver transplantation from living related donors between August 1995 and May 1998.
RESULTS
Mean age and body weight were 14 (range; 6-29) months, 8.7 (range: 5.4-12.2) kg, respectively. The most common cause of end stage liver disease was biliary atresia. After reperfusion there were significant decreases of mean arterial pressure and body temperature, and increases of central venous pressure (P< 0.05), whereas the change of heart rate was not significant. The incidence of postreperfusion syndrome was 26%. Serum Na levels increased significantly (P< 0.05) from 133 3 to 144+/-3 mEq/L, and K level decreased from 4.1+/-0.7 to 3.2+/-0.5 mEq/L during surgery. Hematocrit was 26+/-3.5%, platelet 10.3+/-7.2 x 104/mm3 at the time of peritoneal closure. Wide inter-individual RBC and FFP requirements were observed, 43+/-40 (range: 5-133) mL/kg, 108+/-82 (range: 22-300) mL/kg, respectively.
CONCLUSIONS
We conclude that anesthetic management for pediatric LRLT and LRLT in recipients less than 15 kg in body weight can be carrid out, through with some precautions.

Keyword

Anesthesia, pediatric; Liver, transplantation

MeSH Terms

Arterial Pressure
Biliary Atresia
Blood Platelets
Body Temperature
Body Weight
Central Venous Pressure
End Stage Liver Disease
Heart Rate
Hematocrit
Humans
Incidence
Liver Transplantation*
Liver*
Medical Records
Mortality
Reperfusion
Retrospective Studies
Tissue Donors
Transplants