Anaesthetic Considerations for Orthotopic Liver Transplantation
Mohamed Sayed Mohamed Abbas;
Abstract
Liver is the largest and most heaviest organ in the human body. It perfonns a lot of important physiological functions including excretory , synthetic , storage function , drug detoxification and metabolism and different metabolic functions as carbohydrate , lipid and protein metabolism.
End-stage liver disease is caused by a variety of chronic diseases such as chronic active viral hepatitis , biliary cirrhosis , metabolic diseases and alcoholic liver cirrhosis and patients with OLT will suffer from disturbances in the metabolic , haematological and homeostatic function as well as portal hypertension and hepatic encephalopathy.
From here arises the need of OLT in these patients to save guard them against the hannful effects of end-stage liver disease and also in patients with fulminant hepatic failure.
Liver transplantation has evolved from a rare and risky operation of questionable therapeutic value to the preferred treatment for an extensive list of end-stage liver diseases.
OLT is considered in four phases. The preanhepatic phase in which the liver is mobilized, thanhepatic phase in which the liver is removed and is often accompanied by vena venous bypass, the third or neohepatic phase in which the new liver graft is reperfused and the fourth one is
postanhepatic phase in which the operation is completed. Each phase requires careful consideration by the anaesthesiologist.
End-stage liver disease is caused by a variety of chronic diseases such as chronic active viral hepatitis , biliary cirrhosis , metabolic diseases and alcoholic liver cirrhosis and patients with OLT will suffer from disturbances in the metabolic , haematological and homeostatic function as well as portal hypertension and hepatic encephalopathy.
From here arises the need of OLT in these patients to save guard them against the hannful effects of end-stage liver disease and also in patients with fulminant hepatic failure.
Liver transplantation has evolved from a rare and risky operation of questionable therapeutic value to the preferred treatment for an extensive list of end-stage liver diseases.
OLT is considered in four phases. The preanhepatic phase in which the liver is mobilized, thanhepatic phase in which the liver is removed and is often accompanied by vena venous bypass, the third or neohepatic phase in which the new liver graft is reperfused and the fourth one is
postanhepatic phase in which the operation is completed. Each phase requires careful consideration by the anaesthesiologist.
Other data
| Title | Anaesthetic Considerations for Orthotopic Liver Transplantation | Other Titles | الاعتبارات التخديرية فى عمليات زراعة الكبد | Authors | Mohamed Sayed Mohamed Abbas | Issue Date | 2002 |
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