Related Experiment Video
Updated: Aug 16, 2026
Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt
Published on: May 7, 2015
[Hemodynamic changes during anesthesia in orthotopic liver transplantation in 1-5-year-old children]
Insights
Anesthetic management for pediatric orthotopic hepatic transplantation (OHT) in young children (1-5 years) was evaluated. Balanced general anesthesia with specific drug protocols demonstrated effective cardiovascular system management during these complex surgeries.
Area of Science:
- Pediatric Anesthesiology
- Hepatobiliary Surgery
- Transplant Medicine
Context:
- Orthotopic hepatic transplantation (OHT) in children presents unique anesthetic challenges.
- Limited data exists on anesthetic management protocols for very young pediatric recipients.
- Living related donor OHT requires careful hemodynamic monitoring.
Purpose:
- To analyze anesthetic management strategies for pediatric OHT.
- To study cardiovascular system dynamics during OHT in children aged 1-5 years.
- To identify patterns of hemodynamic impairments in pediatric OHT under balanced general anesthesia.
Summary:
- Evaluated anesthetic management in 49 children (1-15 years) undergoing OHT, focusing on 10 protocols for those aged 1-5 years.
- Utilized balanced general anesthesia with midazolam, ketamine, fentanyl, and pipecuronium bromide.
- Employed low-flow isoflurane inhalation (0.8-2.0% ALC, 0.7-1.6 MAC) for maintenance.
Impact:
- Provides insights into effective anesthetic techniques for pediatric OHT.
- Contributes to understanding hemodynamic stability in young transplant recipients.
- Informs anesthetic protocol development for pediatric liver transplantation.
Abstract:
The anesthetic management of orthotopic hepatic transplantation (OHT) was analyzed in 49 children aged 1 to 15 years. Ten protocols of anesthesia implemented in small-age children (1 to 5 years) were analyzed in detail. The mean age of children (6 girls, 4 boys), operated on in 2002-2004, was 3.0 +/- 2.7 years; their mean weight was 13.6 +/- 4.17 (9-22) kg. The purpose of the case study was to study the dynamics of the cardiovascular system and the pattern of hemodynamic impairments accompanying the anesthetic course in OHT from a living related donor. All surgeries were made under balanced general anesthesia: induction - midazol (0.04 +/- 0.01 mg/kg), cetamine (2.77 +/- 0.64 mg/kg), phentanile (3.1 +/- 0.21 mg/kg), myorelaxation--pipecuronium bromide (arduan) (80.3 +/- 11.44 microg/kg). Low-flow inhalation by isofluoran -0.8-2.0 ALC%, minimal-flow (0.7-1.6 MAC), was used.
