The purpose of this study was to evaluate the perioperative anesthetic management of orthotopic liver transplant (OLT) recipients who had undergone nontransplant surgery at Baskent University Hospital.
Methods: Charts of 22 OLT recipients who had undergone nontransplant surgery between December 1988 and February 2006 were retrospectively reviewed. Twenty-two patients underwent 32 nontransplant elective surgeries. The mean age at the time of transplantation was 20±18 years. The mean interval from liver transplantation to first surgery was 739.1±502.2 days. The most frequent type of surgery was abdominal (28.1%) followed by orthopedic (18.8%), gynecologic (18.8%), ear/nose/throat (9.4%), pediatric (9.4%), and neurologic (9.4%). Types of anesthetic techniques used were general (75%), regional (9.4%), local (9.4%), and sedoanalgesia (6.3%). General anesthesia was induced using thiopental, propofol or ketamine, and maintained with isoflurane and N2O. Fentanyl was used in 91.7% of the patients. Endotracheal intubation was performed in 43.8% of the patients with vecuronium (76.9%) or atracurium (23.1%). Spinal anesthesia and peripheral neural blockage was performed in 3 and 2 patients, respectively. Serum alanine
transaminase, aspartate transaminase, prothrombin time, activated partial thromboplastin time and bilirubin levels were similar between preoperative and the first postoperative day after surgery (P>.05). There were no intraoperative complications or hospital mortalities. In this study, neither regional nor general anesthetic techniques were associated with deterioration of liver functions. According to these results, we suggest that OLT recipients may undergo nontransplant surgeries without postoperative graft dysfunction provided hepatic perfusion is maintained with appropriate anesthetic management.