探索活体肝移植的麻醉管理：来自移植麻醉进步学会和韩国移植麻醉医师学会的调查。
Exploring Anesthesiology Management of Living Donor Liver Transplantation: Survey From the Society for the Advancement of Transplant Anesthesia and the Korean Society for Transplantation Anesthesiologists.
机构信息
Department of Anesthesiology, University of Colorado, Aurora, Colorado, USA.
Department of Anesthesiologists and Pain Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.
出版信息
Clin Transplant. 2024 Oct;38(10):e15428. doi: 10.1111/ctr.15428.
INTRODUCTION
While living donor liver transplantation (LDLT) serves as the predominant method of adult liver transplant (LT) in the Republic of Korea (ROK), it represents a minority of LT in the United States (US). A survey was conducted to gain insight into these nations' anesthetic management.
METHODS
An electronic questionnaire was distributed to directors of LT anesthesiology overseeing LDLT programs in both countries between May 2021 and October 2021.
RESULTS
The response rate was 93.0% (100% [37/37] in the US and 80% [16/20] in the ROK). Both countries mainly adhered to deceased donor LT recipient management practices, including the frequency of routine pulmonary artery catheter use, transesophageal echocardiography, and point-of-care coagulation monitoring. Differences were observed in early extubation of recipients (US vs. ROK: 39.7% vs. 14.7% of all cases), participation in donor selection meetings (88.9% [32/36] vs. 6.3% [1/16], p < 0.0001), application of the Enhanced Recovery After Surgery donor protocol (69.4% [25/36] vs. 12.5% [2/16], p < 0.0001), and cell saver usage for donors (94.4% [34/36] vs. 18.8% [3/16], p < 0.0001). More ROK programs implemented simultaneous donor/recipient anesthesia supervision by a single anesthesiologist.
CONCLUSIONS
Several important differences were identified between the US and the ROK in adult LDLT anesthetic management.
简介
在韩国（ROK），活体供肝移植（LDLT）是成人肝移植（LT）的主要方法，但在美国（US），它只占 LT 的一小部分。进行了一项调查，以深入了解这两个国家的麻醉管理情况。
方法
2021 年 5 月至 2021 年 10 月期间，向两国负责 LDLT 项目的 LT 麻醉主任分发了电子问卷。
结果
回复率为 93.0%（美国为 100%[37/37]，韩国为 80%[16/20]）。两国主要遵循已故供体 LT 受者管理实践，包括常规肺动脉导管使用、经食管超声心动图和即时凝血监测的频率。在受者的早期拔管方面存在差异（美国与韩国：所有病例中的 39.7%[39/37]与 14.7%[16/20]），参与供者选择会议（88.9%[32/36]与 6.3%[1/16]，p<0.0001），应用术后快速康复供者方案（69.4%[25/36]与 12.5%[2/16]，p<0.0001），以及供者使用血细胞分离机（94.4%[34/36]与 18.8%[3/16]，p<0.0001）。更多的韩国项目由一名麻醉师同时对供者/受者进行麻醉监督。
结论
在美国和韩国的成人 LDLT 麻醉管理中，发现了几个重要的差异。
Zotero 插件