Zerillo J, Kim S, Hill B, Shapiro D, Lin HM, Burnham A, Moon J, Iyer K, DeMaria S. Anesthetic management for intestinal transplantation: A decade of experience.
Clin Transplant 2017;
31. [PMID:
28801969 DOI:
10.1111/ctr.13085]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND
Intestinal transplantation (ITx) is the definitive therapy for patients suffering from intestinal failure. Previously published reports suggest that these cases should be managed perioperatively with the same intensive monitors and techniques as in liver transplantation.
METHODS
We retrospectively reviewed the anesthetic management of 67 isolated intestinal, intestinal-pancreas, and intestinal-kidney transplants over the previous decade (2005-2015) in our tertiary care institution.
RESULTS
Patients were typically managed with a single arterial line, a single central venous catheter, and rarely intensive modalities such as a pulmonary artery catheter, a transesophageal echocardiography, a second arterial catheter or central venous catheter, a rapid infusion system, a cell salvage device, or viscoelastic testing. Significant hemodynamic derangements were rare, and the rate of postreperfusion syndrome was 8.96%. Our fluid administration type and volume and transfusion type and volume were similar to previous reports in which more intensive anesthetic management was employed.
CONCLUSION
We demonstrate that ITx can safely occur without utilizing the intensive resources requisite for a liver transplant.
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