Management of liver transplantation perioperative period in acute-on-chronic liver failure.
10.3760/cma.j.cn501113-20230304-00094-1
- Author:
Bo QI
1
;
Li Qun YANG
1
;
He Xin YAN
1
;
Wei Feng YU
1
Author Information
1. Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200433, China.
- Publication Type:Journal Article
- Keywords:
Acute-on-chronic liver failure;
Liver transplantation;
Organ protection;
Perioperative management
- MeSH:
Humans;
Liver Transplantation;
Acute-On-Chronic Liver Failure/surgery*;
Liver Cirrhosis/complications*;
Perioperative Period;
Prognosis
- From:
Chinese Journal of Hepatology
2023;31(6):564-568
- CountryChina
- Language:Chinese
-
Abstract:
Acute-on-chronic liver failure (ACLF) is a potentially reversible entity that occurs in patients with chronic liver disease accompanied with or without cirrhosis and is characterized by extrahepatic organ failure and high short-term mortality. Currently, the most effective treatment method for patients with ACLF is liver transplantation; therefore, admission timing and contraindications must be emphasized. The function of vital organs such as the heart, brain, lungs, and kidneys should be actively supported and protected during the liver transplantation perioperative period in patients with ACLF. Focusing on the anesthesia management level during anesthesia selection, intraoperative monitoring, three-stage management, prevention and treatment of post-perfusion syndrome, monitoring and management of coagulation function, volume monitoring and management, and body temperature monitoring management for liver transplantation should strengthen anesthesia management. Additionally, standard postoperative intensive care treatment should be recommended, and grafts and other vital organ functions should be monitored throughout the perioperative period to promote early postoperative recovery in patients with ACLF.
