Skip to main content
SpringerLink
Log in

Lebertransplantation

  • Chapter
  • First Online:
Evidenzbasiertes perioperatives Management in der Viszeralchirurgie

Part of the book series: Evidenzbasierte Chirurgie ((EC))

  • 1295 Accesses

Zusammenfassung

Dieses Kapitel fußt unter anderem auf Empfehlungen der International Liver Transplantation Society. Daneben wird ein Protokoll zu ERAS bei Lebertransplantation vorgestellt. Zur perioperativen Antibiotikaprophylaxe bei Lebertransplantation wird ein Cephalosporin der 3. Generation plus Ampicillin oder Piperacillin/Tazobactam für bis zu 24 h empfohlen. Die Empfehlungen eines Expertengremiums zum perioperativen Gerinnungsmanagement bei Lebertransplantatempfänger werden referiert. Die Gabe von Aprotinin, rekombinantem Faktor VIIa und die Kontrolle der Blutgerinnung mittels Thrombelastographie können möglicherweise Blutverlust und Transfusionsbedarf senken. Morphin wird in vielen postoperativen Schmerzprotokollen nach Lebertransplantation ausgeschlossen, weil es mit einem höheren Risiko an Sedierung und Atemdepression assoziiert ist. Fentanyl erfordert für seine Metabolisierung sehr wenig Leberrestfunktion. Es kann das Opioid der Wahl bei schlechter Transplantatfunktion sein.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 74.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literatur

  • Abbo LM, Grossi PA, AST ID Community of Practice (2019) Surgical site infections: guidelines from the American society of transplantation infectious diseases community of practice. Clin Transplant 33:e13589

    Google Scholar 

  • Berry PS, Rosenberger LH, Guidry CA, Agarwal A, Pelletier S, Sawyer RG (2019) Intraoperative versus extended antibiotic prophylaxis in liver transplant surgery: a randomized controlled pilot trial. Liver Transpl 25:1043–1053

    Article  Google Scholar 

  • Bezinover D, Dirkmann D, Findlay J et al (2018) Perioperative coagulation management in liver transplant recipients. Transplantation 102:578–592

    Article  Google Scholar 

  • Brustia R, Monsel A, Conti F, Savier E, Rousseau G, Perdigao F, Bernard D, Eyraud D, Loncar Y, Langeron O, Scatton O (2019) Enhanced recovery in liver transplantation: a feasibility study. World J Surg 43:230–241

    Article  Google Scholar 

  • Carrier FM, Chassé M, Wang HT, Aslanian P, Iorio S, Bilodeau M, Turgeon AF (2020) Restrictive fluid management strategies and outcomes in liver transplantation: a systematic review. Can J Anaesth 67:109–127

    Article  Google Scholar 

  • Chan S, Ng S, Chan HP, Pascoe EM, Playford EG, Wong G, Chapman JR, Lim WH, Francis RS, Isbel NM, Campbell SB, Hawley CM, Johnson DW (2020) Perioperative antibiotics for preventing post-surgical site infections in solid organ transplant recipients. Cochrane Database Syst Rev 8(8):CD013209

    PubMed  Google Scholar 

  • Cywinski JB, Alster JM, Miller C, Vogt DP, Parker BM (2014) Prediction of intraoperative transfusion requirements during orthotopic liver transplantation and the influence on postoperative patient survival. Anesth Analg 118:428–437

    Article  Google Scholar 

  • Feltracco P, Carollo C, Barbieri S, Milevoj M, Pettenuzzo T, Gringeri E, Boetto R, Ori C (2014) Pain control after liver transplantation surgery. Transplant Proc 46:2300–2307

    Article  CAS  Google Scholar 

  • Feltracco P, Barbieri S, Cillo U, Zanus G, Senzolo M, Ori C (2015) Perioperative thrombotic complications in liver transplantation. World J Gastroenterol 21:8004–8013

    Article  Google Scholar 

  • Gurusamy KS, Pissanou T, Pikhart H, Vaughan J, Burroughs AK, Davidson BR (2011) Methods to decrease blood loss and transfusion requirements for liver transplantation. Cochrane Database Syst Rev 12:CD009052

    Google Scholar 

  • Han S, Kwon JH, Jung SH, Seo JY, Jo YJ, Jang JS, Yeon SM, Jung SH, Ko JS, Gwak MS, Cho D, Son HJ, Kim GS (2018) Perioperative fresh red blood cell transfusion may negatively affect recipient survival after liver transplantation. Ann Surg 267:346–351

    Article  Google Scholar 

  • Han S, Park HW, Song JH, Gwak MS, Lee WJ, Kim G, Lee SK, Ko JS (2016) Association between intraoperative platelet transfusion and early graft regeneration in living donor liver transplantation. Ann Surg 264:1065–1072

    Article  Google Scholar 

  • Hevesi ZG, Lopukhin SY, Mezrich JD, Andrei AC, Lee M (2009) Designated liver transplant anesthesia team reduces blood transfusion, need for mechanical ventilation, and duration of intensive care. Liver Transpl 15:460–465

    Article  Google Scholar 

  • Miller CM, Quintini C, Dhawan A et al (2017) The International liver transplantation society living donor liver transplant recipient guideline. Transplantation 101:938–944

    Article  Google Scholar 

  • Mukerji AN, Karachristos A, Maloo M, Johnson D, Jain A (2014) Do postliver transplant patients need thromboprophylactic anticoagulation? Clin Appl Thromb Hemost 20:673–677

    Article  Google Scholar 

  • Paugam-Burtz C, Chatelon J, Follin A, Rossel N, Chanques G, Jaber S (2010) Prise en charge anesthésique des transplantations hépatiques: évolution des pratiques périopératoires en France entre 2004 et 2008 [Perioperative anaesthetic practices in liver transplantation in France: evolution between 2004 and 2008]. Ann Fr Anesth Reanim 29:419–424

    Article  CAS  Google Scholar 

  • Plauth M, Bernal W, Dasarathy S, Merli M, Plank LD, Schütz T, Bischoff SC (2019) ESPEN guideline on clinical nutrition in liver disease. Clin Nutr 38:485–521

    Article  Google Scholar 

  • Rao JH, Zhang F, Lu H, Dai XZ, Zhang CY, Qian XF, Wang XH, Lu L (2017) Effects of multimodal fast-track surgery on liver transplantation outcomes. Hepatobiliary Pancreat Dis Int 16:364–369

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. DIGG der DGG, Berlin, Deutschland

    Reinhart T. Grundmann

  2. Klinik und Poliklinik für Gefäßmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    E. Sebastian Debus

Authors
  1. Reinhart T. Grundmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Sebastian Debus
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Reinhart T. Grundmann .

Editor information

Editors and Affiliations

  1. DIGG der DGG, Burghausen, Deutschland

    Reinhart T. Grundmann

  2. Klinik und Poliklinik für Gefäßmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    E. Sebastian Debus

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Der/die Autor(en), exklusiv lizenziert durch Springer-Verlag GmbH, DE, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Grundmann, R.T., Debus, E.S. (2021). Lebertransplantation. In: Grundmann, R.T., Debus, E.S. (eds) Evidenzbasiertes perioperatives Management in der Viszeralchirurgie. Evidenzbasierte Chirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-62848-5_26

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-62848-5_26

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-62847-8

  • Online ISBN: 978-3-662-62848-5

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation