Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Clinical and Translational Science Institute, University of Pittsburgh, Pennsylvania, USA.
Clin Transplant. 2022 Jun;36(6):e14667. doi: 10.1111/ctr.14667. Epub 2022 Apr 24.
Living donor liver transplantation was first developed to mitigate the limited access to deceased donor organs in Asia in the 1990s. This alternative liver transplantation option has become an established and widely practiced transplantation method for adult patients suffering from end-stage liver disease. It has successfully addressed the shortage of deceased donors. The Society for the Advancement of Transplant Anesthesia and the Korean Society of Transplant Anesthesia jointly reviewed published studies on the perioperative management of live donor liver transplant recipients. The review aims to offer transplant anesthesiologists and critical care physicians a comprehensive overview of the perioperative management of adult live liver transplantation recipients. We feature the status, outcomes, surgical procedure, portal venous decompression, anesthetic management, prevention of acute kidney injury, avoidance of blood transfusion, monitoring and therapeutic strategies of hemodynamic derangements, and Enhanced Recovery After Surgery protocols for liver transplant recipients.
活体肝移植最初是为了缓解 20 世纪 90 年代亚洲供体器官有限的问题而发展起来的。这种替代肝移植的选择已成为治疗终末期肝病成年患者的一种成熟且广泛应用的移植方法。它成功地解决了供体短缺的问题。移植麻醉学会和韩国移植麻醉学会共同审查了关于活体供肝移植受者围手术期管理的已发表研究。该综述旨在为移植麻醉师和重症监护医师提供成人活体肝移植受者围手术期管理的全面概述。我们介绍了成人活体肝移植受者的现状、结果、手术过程、门静脉减压、麻醉管理、急性肾损伤的预防、避免输血、血流动力学紊乱的监测和治疗策略，以及肝移植受者的术后快速康复方案。
