Perioperative Care for Liver Transplantation: A Review

摘要

I am quite honored to be editing the third volume of International Anesthesiology Clinics on the topic of liver transplantation. The first 2 were published in 2006, with significant clinical expertise and input from foreign centers. For this volume, I have invited Dr A. Pustavoitau, a faculty intensivist and anesthesiologist at the Johns Hopkins Hospital, to share in the selection and editing process. After extensive animal research, the first human liver transplant was performed in 1963. At that time, roughly 15,000 people between 5 and 60 years of age were dying of liver-related illness annually in the United States, 90% from cirrhosis. It was an experimental surgical procedure through the 1970s: the recipients were profoundly ill—1-year survival did not occur until 1967—and by the mid-1970s, the 1-year survival had improved to only around 25%. Techniques were in development; merely getting out of the operating room was a demanding effort for both surgeons and anesthesiologists, not to mention the significant preoperative and postoperative issues. By 1981, after considerable debate, guidelines were improved for the declaration of death, and thus the potential for organ donation both cardiopulmonary death and brain death.