2. ANESTHESIA IN PEDIATRIC LIVER TRANSPLANTATION - EXPERIENCES OF CHILDREN HOSPITAL 2
Main Article Content
Abstract
Objective: Evaluating the initial results of anesthesia for pediatric liver transplantation at Children Hospital 2: the results achieved and the problems still exist.
Designe: Conducting anesthesia in pediatric liver transplant surgery in three phrases from 2005-2019, 2021-2022 and 2023-2025. From the support of anesthesiologists from Belgium in the early stage to autonomy in anethesia.
Results: From December 2005 to June 2025 we performed general anesthesia in pediatric liver transplant surgeries in 54 patients having end-stage liver disease (ESLD), with 52 living donnors and 2 deceased donnors. Patient age from 7,5 to 132 months old in young female than male (29/25), and average weight 11,5kg (6,8-27 kg); With 47 patients had biliary atresia, 1 Alagille syndrome, 2 Budd Chiari syndromes and 4 PFIC. There were 7 cases having hepatopulmonary syndromes, 2 had pulmonary hypertension and 1 had hepatic encephalopathy. All of them had trouble of hemostasis that 10 patients were massive blood transfusions. The average duration of anesthesia was 11hours 25 minutes (08:30-13:20). Extubation were performed in the 1st or 2nd postoperative day.
Conclusion: Anesthetic management was contributing to the initial success of pediatric liver transplantation from living donor at Children Hospital 2. To ensure more safety for patients, it’s necessary to profoundly understand of the physiological and metabolic changes in ESLD. Remarkable changes during operation should be managed. Close communication between surgical team and the anesthesiologists is the most important issue in patient management.
Article Details
Keywords
Liver transplantation, child, anesthesia.
References
[2] Bhananker S.M, Ramamoorthy C, Geiduschek J.M, Posner K.L, Domino K.B, Haberkern C.M et al. Anesthesia-related cardiac arrest in children: update from the Pediatric Perioperative Cardiac Arrest Registry, Anesth Analg, 2007, 105: 344-50.
[3] Cox K.L, Berquist W.E, Castillo R.O. Pediatric liver transplantation: indications, timing and medical complications. J Gastroenterol Hepatol, 1999, 14 Suppl: S61-6.
[4] Greene N, Bhananker S.M, Ramaiah R. Vascular access, fluid resuscitation, and blood transfusion in pediatric trauma. Int J Crit Illn Inj Sci, 2012, 2: 135-42.
[5] Eun Jung Kim, Bon-Nyeo Koo. Anesthetic Management in Pediatric Liver Transplantation. J Korean Soc Transplant, 2018, 32 (3): 31-37.
[6] Fullington N.M, Cauley R.P, Potanos K.M, O’Melia L, Zurakowski D, Bae Kim H et al. Immediate extubation after pediatric liver transplantaion: a single - center experience. Liver Transpl, 2015, 21: 57-62.
[7] Maria A, Pamecha V, Kaushal S, et al. Rotational throboelastometry - guided blood componentuse in cirrhortic children undergoing invasive procedures: A randomized controlled trial.Liver Int, 2022, 42 (11): 2453-2463. doi: 10. 10.1111/liv.15397.
[8] O’Meara M.E, Whiteley S.M, Sellors J.M, Luntley J.M, Davison S, McClean P et al. Immediate extubation of children following liver transplantation is safe and may be beneficial. Transplantation, 2005, 80: 959-63.
[9] Stevonson J.G. Incidence of complications in pediatric transesophageal echocardiography: experience in 1650 cases. J Am Soc Echocardiogr, 1999, 12: 527-32.
[10] Perkin R.M, Anas N. Pulmonary artery catheters. Pediatr Crit Care Med, 2011, 12 4 Suppl: S12-S20.
[11] Thanh Tri Tran, Phi Duy Ho, Nguyen An Thuan Luu, Thi Yen Nhi Truong, Hong Van Khanh Nguyen, Hai Trung Bui, Ngoc Thach Pham, Dong A Tran, Thierry Pirotte, Raymond Reding. Implementating living donor pediatric liver transplantation in Southern Vietnam: 15-year results and perspectives. Pediatric Transplantation, 2022, 00: e1441. ttps://doi.org/10.1111/petr.14441