Anesthetic management for small bowel transplantation

Abstract

Small bowel transplantation is quickly becoming the therapy of choice for short-gut syndrome. Improvements in surgical techniques, immunosuppressants, and anesthetic management of patients have allowed this procedure to become the standard of care for patients with irreversible intestinal failure who are unable to continue total parenteral nutrition therapy. This article discusses the evaluation process for candidate selection, including work-up for vascular access and hypercoagulability, intraoperative management of patients (including appropriate monitoring, hemodynamic changes, fluid management, surgical techniques, and effects of immunosuppressants), and patient survival and outcome.