Anesthetic Management for Pediatric Living Related Liver Transplantation: Experience of 30 Cases.
10.4097/kjae.1999.37.3.419
- Author:
Kyu Sam HWANG
1
;
Kyu Taek CHOI
;
Yu Mee LEE
;
So Young LEE
;
Sung Keun PARK
;
Cheong LEE
Author Information
1. Department of Anesthesiology, College of Medicine, Ulsan University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Anesthesia, pediatric;
Liver, transplantation
- MeSH:
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
- From:Korean Journal of Anesthesiology
1999;37(3):419-425
- CountryRepublic of Korea
- Language:Korean
-
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.
