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Preoperative Assessment and Optimization of Liver Transplant Patients: Pulmonary Issues

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Peri-operative Anesthetic Management in Liver Transplantation

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Abstract

Patients with end-stage liver disease need to be carefully evaluated and optimized prior to liver transplant for best possible outcome. Pulmonary disorders are commonly seen in this population, and they have a significant impact on perioperative risk. Preoperative pulmonary impairment causes intraoperative alteration in respiratory function and increased postoperative complications, which may limit the survival rate. Regardless of the cause of liver failure, certain pulmonary symptoms occur in chronic liver failure. Long-standing ascites may cause muscle wasting, atelectasis, and dyspnea. Pulmonary disorders in these patients are pulmonary vascular complications (hepatopulmonary syndrome, portopulmonary hypertension), hepatic hydrothorax, and others like COPD, cystic fibrosis, α1 antitrypsin deficiency, and interstitial lung disease. These days we are getting older patients for liver transplant likely to have more pulmonary comorbidities. A thorough preoperative evaluation and management is of utmost importance for good outcome.

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Author information

Authors and Affiliations

  1. Department of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital, New Delhi, India

    Anjali Gera & Deepanjali Pant

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  1. Anjali Gera
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  2. Deepanjali Pant
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Editors and Affiliations

  1. Liver Transplant, GI Anesthesia & Intensive Care, Medanta The Medicity, Gurgaon, India

    Vijay Vohra

  2. Liver Transplant, GI Anesthesia & Critical Care, Medanta The Medicity, Gurgaon, Haryana, India

    Nikunj Gupta

  3. Liver Transplant & General Anaesthesia, Narayana Superspeciality Hospital, Gurgaon, India

    Annu Sarin Jolly

  4. Liver Transplant, GI Anesthesia & Critical Care, Formerly at Medanta The Medicity, Gurgaon, India

    Seema Bhalotra

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Gera, A., Pant, D. (2023). Preoperative Assessment and Optimization of Liver Transplant Patients: Pulmonary Issues. In: Vohra, V., Gupta, N., Jolly, A.S., Bhalotra, S. (eds) Peri-operative Anesthetic Management in Liver Transplantation. Springer, Singapore. https://doi.org/10.1007/978-981-19-6045-1_12

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  • DOI: https://doi.org/10.1007/978-981-19-6045-1_12

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