Circulatory pathophysiology and options in hemodynamic management during adult liver transplantation

Mandell, M. Susan; Katz, Joshua; Wachs, Michael; Gill, E; Kam, Igal

doi:10.1002/lt.500030411

Cited by 21 publications

(7 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Vasopressin has been shown to have a stimulation effect on lactate production by liver cells and adipose tissue in the septic model [ 41 ]. In our study, the lactate concentrations with vasopressin use were higher during the pre-reperfusion stage.…”

Section: Effects Of Catecholamines and Vasoactive Agents On Lactate Pmentioning

confidence: 99%

Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease Patient

Vitin

Azamfirei

Tomescu

et al. 2017

The Journal of Critical Care Medicine

View full text Add to dashboard Cite

Lactic acidosis (LA) in end-stage liver disease (ESLD) patients has been recognized as one of the most complicated clinical problems and is associated with increased morbidity and mortality. Multiple-organ failure, associated with advanced stages of cirrhosis, exacerbates dysfunction of numerous parts of lactate metabolism cycle, which manifests as increased lactate production and impaired clearance, leading to severe LA-induced acidemia. These problems become especially prominent in ESLD patients, that undergo partial hepatectomy and, particularly, liver transplantation. Perioperative management of LA and associated severe acidemia is an inseparable part of anesthesia, post-operative and critical care for this category of patients, presenting a wide variety of challenges. In this review, lactic acidosis applied pathophysiology, clinical implications for ESLD patients, diagnosis, role of intraoperative factors, such as anesthesia and surgery-related, vasoactive agents impact, and also current treatment options and modalities have been discussed.

show abstract

Section: Effects Of Catecholamines and Vasoactive Agents On Lactate Pmentioning

confidence: 99%

Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease Patient

Vitin

Azamfirei

Tomescu

et al. 2017

The Journal of Critical Care Medicine

View full text Add to dashboard Cite

show abstract

“…The immediate hemodynamic stabilization (on the face of severely compromised myocardial function, in combination with rapid decrease in SVR, observed during postreperfusion stage), which all these drug combinations provide, should be further maintained with continuous infusion administration of vasoactive agents, such as phenylephrine or vasopressin, targeting primarily reduction of systemic vascular resistance. Compromised myocardial performance due to preexisting dilated cardiomyopathy and especially its worsening after graft reperfusion oftentimes necessitates addition of agents with β-adrenergic activities, such as norepinephrine, and, rarely, epinephrine [82,83].…”

Section: Management: Possible Treatment Optionsmentioning

confidence: 99%

Nonischemic Cardiomyopathy in Liver Transplant Recipients

Vitin¹,

Tomescu²,

Azamfirei³

2019

Liver Cirrhosis - Debates and Current Challenges

View full text Add to dashboard Cite

Nonischemic cardiomyopathy is a collective term, encompassing a spectrum of cardiac comorbidities, accompanying the progressing end-stage liver disease. Alcoholic and cirrhotic cardiomyopathies are the most researched, well-known clinical entities in the list of nonischemic cardiac disorders that bear the most substantial impact on the clinical course, management, and outcomes of liver transplantation in ESLD patients. In this chapter, morphology, pathophysiology, diagnostic criteria, clinical manifestations, and management options of nonischemic cardiomyopathy in liver transplant candidates and recipients, the patients with end-stage liver disease due to advanced stages of cirrhosis, are discussed.

show abstract

“…Low-dose vasopressin infusion is proved to be safe: to date, no cases of liver graft damage have been documented. To the contrary, cases where a high-dose of vasopressin (0.8 U) bolus, followed by a vasopressin infusion (4U/h) to attenuate refractory hypotension secondary to graft reperfusion, was used without causing any identifiable liver graft damage, have been reported [102]. Vasopressin has been shown to have a stimulation effect on lactate production by liver cells and adipose tissue in the septic model [103], and to be able to decrease blood loss during pre-and anhepatic phases of OLT (namely, EBL before graft reperfusion has been decreased by 50.2% [104] Hemodynamic Optimization Strategies in Anesthesia Care for Liver Transplantation http://dx.doi.org/10.5772/intechopen.68416…”

Section: Vasoactive Agents Applied Pharmacology and Use In Hemodynamimentioning

confidence: 99%

Hemodynamic Optimization Strategies in Anesthesia Care for Liver Transplantation

Vitin¹,

Tomescu²,

Azamfirei³

2017

Liver Cirrhosis - Update and Current Challenges

View full text Add to dashboard Cite

In this chapter, aspects of hemodynamic regulation in the end-stage liver disease (ESLD) patient, factors, contributing to the hemodynamic profile, coagulation-related problems, blood products transfusion tactics and problems, and hemodynamic optimization strategies during different stages of liver transplantation procedure-specifically what, when, and how to correct, with special attention to vasoactive agents use, will be discussed.

show abstract

Circulatory pathophysiology and options in hemodynamic management during adult liver transplantation

Cited by 21 publications

References 52 publications

Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease Patient

Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease Patient

Nonischemic Cardiomyopathy in Liver Transplant Recipients

Hemodynamic Optimization Strategies in Anesthesia Care for Liver Transplantation

Contact Info

Product

Resources

About