Anesthesia for liver transplantation in United States academic centers: intraoperative practice

Abstract

Study objective: To determine current practice patterns for patients receiving liver transplantation.

Design: International, web-based survey instrument.

Setting: Academic medical centers.

Measurements: Survey database responses to questions about liver transplant anesthesiology programs and current intraoperative anesthetic care and resource utilization were assessed. Descriptive statistics of intraoperative practices and resource utilization according to the size of the transplant program were recorded.

Main results: Anesthetic management practices for liver transplantation varied across the academic centers. The use of cell salvage (Cell Saver®), transesophageal echocardiography, thrombelastography, and ultrasound guidance for catheter placement varies among institutions.

Conclusion: Effective practices and more evidence-based intraoperative management have not yet been applied in many programs. Many facets of perioperative liver transplantation anesthesia care remain underexplored.

Keywords: Coagulation management; Evidence-based practice; Hemodynamic monitoring; Invasive monitoring; Liver transplantation outcomes; Resource utilization; Transesophageal echocardiography.