Abstract
Since the first kidney transplant, advancements in the care of solid organ transplant patients have included advancements in the intraoperative anesthetic care. Anesthesiologists specializing in the care of children undergoing solid organ transplant are integral members of the transplant team. Their experience and knowledge are an important part of the initial evaluation phase, the preoperative planning, intraoperative care, and postoperative care of this patient population.
Preoperatively, the pediatric transplant anesthesiologist performs an in-depth examination and evaluation of each patient. The combination of past medical history and current medical conditions helps to identify possible intraoperative challenges and plan for the safest possible intraoperative course.
Intraoperatively, the anesthesiologist is responsible for the overall care of the patient and is quick to respond to both the expected as well as unexpected changes in the patient’s medical condition. Each type of transplant has different stages during the operation. Close communication and a familiar operating room team are needed to ensure a smooth transition between stages as well as rapid response to unexpected events that are encountered during these difficult surgeries.
Postoperatively, the pediatric transplant anesthesiologist is an important part of transitioning the patient from an anesthetized state in the operating room to the team that will care for them during their recovery. Plans for pain control, respiratory support, and ongoing hemodynamic support are made and initiated by the anesthesiologist in the operating room.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Aggarwal S, Kang Y, Freeman JA et al (1987) Postreperfusion syndrome: cardiovascular collapse following hepatic reperfusion during liver transplantation. Transplant Proc 19:54–55
American Society of Anesthesiologists Committee (2011) Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Committee on standards and practice parameters. Anesthesiology 114:495–511
Bosilkovska M, Walder B, Besson M et al (2012) Analgesics in patients with hepatic impairment: pharmacology and clinical implications. Drugs 72:1645–1669. https://doi.org/10.2165/11635500-000000000-00000
Diamond IR, Fecteau A, Millis JM et al (2007) Impact of graft type on outcome in pediatric liver transplantation: a report from studies of pediatric liver transplantation (SPLIT). Ann Surg 246:301–310. https://doi.org/10.1097/SLA.0b013e3180caa415
Fullington NM, Cauley RP, Potanos KM et al (2014) Immediate extubation after pediatric liver transplantation: a single-center experience. Liver Transpl 21:57–62. https://doi.org/10.1002/lt.24036
Gad EH, Abdelsamee MA, Kamel Y (2016) Hepatic arterial and portal venous complications after adult and pediatric living donor liver transplantation, risk factors, management and outcome (a retrospective cohort study). Ann Med Surg 8:28–39. https://doi.org/10.1016/j.amsu.2016.04.021
Gitlin JD (2003) Wilson disease. Gastroenterology 125(6):1868–1877
Mazzaferro V, Esquivel CO, Makowka L et al (1989) Hepatic artery thrombosis after pediatric liver transplantation – a medical or surgical event? Transplantation 47:971–977
Raffini L, Witmer C (2015) Pediatric transplantation: managing bleeding. J Thromb Haemost 13(Suppl 1):S362–S369. https://doi.org/10.1111/jth.12913
Schmidt J, Kroeber S, Irouschek A et al (2006) Anesthetic management of patients with ornithine transcarbamylase deficiency. Paediatr Anaesth 16:333–337. https://doi.org/10.1111/j.1460-9592.2005.01695.x
Soler X, Myo Bui CC, Aronson LA, Saied AS (2012) Current issues in pediatric liver transplantation. Int Anesthesiol Clin 50:54–65. https://doi.org/10.1097/AIA.0b013e31826e3438
Spada M (2009) Pediatric liver transplantation. World J Gastroentrol 15:648–674. https://doi.org/10.3748/wjg.15.648
Stellingwerff M, Brandsma A, Lisman T, Porte RJ (2012) Prohemostatic interventions in liver surgery. Semin Thromb Hemost 38:244–249. https://doi.org/10.1055/s-0032-1302440
Sunku B, Salvalaggio PRO, Donaldson JS et al (2006) Outcomes and risk factors for failure of radiologic treatment of biliary strictures in pediatric liver transplantation recipients. Liver Transpl 12:821–826. https://doi.org/10.1002/lt.20712
Wan S, Roberts MA, Mount P (2016) Normal saline versus lower-chloride solutions for kidney transplantation. Cochrane Database Syst Rev:CD010741. https://doi.org/10.1002/14651858.CD010741.pub2
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this entry
Cite this entry
Fuhr, P.G., Wilder, M.S., Bielsky, A.R. (2018). Anesthetic Considerations for the Child Undergoing Transplantation. In: Dunn, S., Horslen, S. (eds) Solid Organ Transplantation in Infants and Children. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-07284-5_43
Download citation
DOI: https://doi.org/10.1007/978-3-319-07284-5_43
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-07283-8
Online ISBN: 978-3-319-07284-5
eBook Packages: MedicineReference Module Medicine