Abstract

GRUNBERG, Gustavo; RANDO, Karina  and  ZUNINI, Graciela. Experiencia en la Unidad Bi-Institucional de Trasplante Hepático en Uruguay. Anest Analg Reanim [online]. 2010, vol.23, n.1, pp.6-13. ISSN 1688-1273.

SUMMARY The beginning of a new liver transplant program is an important challenge for all the team and a high level of training is required. The aim of this study was to describe the anesthetic management and outcomes of the first 12 transplanted patients from our program in Uruguay. A retrospective study was performed including all the patients that were operated of liver transplant during the period of July 2009 to May 2010. The anesthetic management was standardized with the anesthetic protocol of our Liver Transplant Unit; complete basic monitoring was according with American Society of Anesthesiologists and invasive monitoring included: continue measurement of central venous pressure, pulmonary artery pressure and arterial blood pressure as well as intermittent pulmonary wedge pressure and bolus cardiac output. Rapid fluid infusion system was available, as well as cell saver, and patient warming systems. Hemodynamic stability and early extubation (7 patients in operating room and 4 in the following 24 hours) were possible with our anesthetic technique. No intraoperative complications related to anesthesia were reported and one reperfusion syndrome was presented. Mild pulmonary edema and renal failure were the most common postoperative complications. Length of stay in intensive care unit was less than 72 hours in 11 patients and only one died because of primary graft non-function. Conclusions: Surgical requirements, early extubation and good hemodynamic management were possible with the anesthetic technique used in our program.

Keywords : Liver transplantation; early extubation; anesthetic management; anesthetic monitoring.

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