General: Liver Transplantation

In this chapter the essential aspects of anesthesia for liver transplantation are reviewed. Subtopics include the systemic manifestations of cirrhosis and their effects on anesthesia planning. Additionally, the hemodynamic consequences of the different stages of liver transplantation—preanhepatic, anhepatic, and reperfusion—are reviewed. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. Preoperative topics include relevant means of assessing cardiac and liver function status. Ascites and hepatorenal syndrome are also discussed. Issues related to intraoperative management include choice of monitor, hematological considerations, and induction. Postoperative topics discussed are postoperative bleeding, and coagulopathy and anemia.