Perioperative management of liver transplant

Anesthesia for liver transplantation poses myriad challenges due to surgical complexity and the multisystem pathophysiology associated with end-stage liver disease. Cirrhosis-related pathologies such as portopulmonary hypertension and hepatorenal syndrome may further complicate perioperative management, and intraoperative complications such as the development of intracardiac thrombus or post-reperfusion syndrome can cause catastrophic hemodynamic consequences that require advanced management, including mechanical circulatory support. This review summarizes recent advances in liver transplant anesthesia to inform best practices for managing this increasingly complex patient population.