Anesthesia and Intensive Care Management for Cardiac Transplantation

Abstract

Patient management in heart transplant is quite complex and includes multiple steps from preoperative recipient evaluation to postoperative ICU treatment. Monitoring, anesthesia induction, and cardiopulmonary bypass weaning strategies are discussed. The success of the operation also depends on right heart support especially in case of pulmonary hypertension. Many details like fluid management, well-timed respiratory weaning, and primary graft dysfunction management can make the difference in terms of outcome. Pediatric heart transplants represent a small group of total cardiac transplant, but the differences in anatomy and physiology make the surgical and anesthesiological management more complex in unique scenario that requires a specific knowledge at different stages of growth, from newborn through childhood up to adulthood.