Anesthetic considerations in parturients with liver transplant

Advances in the surgical technique, safer anesthetic agents, improved hemodynamic monitoring, better pre-operative optimization of cirrhotic patients and postoperative critical care facilities have led to drastic improvement in the outcomes following orthotopic liver transplantation (OLT). Reproduct...

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Main Authors: Anil Agarwal, Amit Jha, Dalim Kumar Baidya, Anjan Trikha
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2014-01-01
Series:Journal of Obstetric Anaesthesia and Critical Care
Subjects:
Online Access:http://www.joacc.com/article.asp?issn=2249-4472;year=2014;volume=4;issue=1;spage=4;epage=11;aulast=Agarwal
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author Anil Agarwal
Amit Jha
Dalim Kumar Baidya
Anjan Trikha
author_facet Anil Agarwal
Amit Jha
Dalim Kumar Baidya
Anjan Trikha
author_sort Anil Agarwal
collection DOAJ
description Advances in the surgical technique, safer anesthetic agents, improved hemodynamic monitoring, better pre-operative optimization of cirrhotic patients and postoperative critical care facilities have led to drastic improvement in the outcomes following orthotopic liver transplantation (OLT). Reproductive dysfunction in patients with end-stage liver disease can be corrected within months of successful orthotopic liver transplantation. Consequently, there is a worldwide increase in the number of women of childbearing potential after orthotopic liver transplantation. Successful pregnancies are now increasingly being reported in these patients. These are high-risk pregnancies as increased medical and obstetric complications and adverse maternal and fetal effects of immunosuppressant medications are likely to be encountered in these patients following liver transplantation. Optimal antenatal and perioperative management in these parturients warrant a multidisciplinary approach and meticulous planning. There is little evidence available regarding anesthetic concerns in this high-risk pregnant population. This review is aimed at addressing important perioperative issues in parturients, who have undergone a successful liver transplantation.
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spelling doaj.art-84e720ecb732431789cf1922dc51a7942022-12-21T17:43:44ZengWolters Kluwer Medknow PublicationsJournal of Obstetric Anaesthesia and Critical Care2249-44722014-01-014141110.4103/2249-4472.132812Anesthetic considerations in parturients with liver transplantAnil AgarwalAmit JhaDalim Kumar BaidyaAnjan TrikhaAdvances in the surgical technique, safer anesthetic agents, improved hemodynamic monitoring, better pre-operative optimization of cirrhotic patients and postoperative critical care facilities have led to drastic improvement in the outcomes following orthotopic liver transplantation (OLT). Reproductive dysfunction in patients with end-stage liver disease can be corrected within months of successful orthotopic liver transplantation. Consequently, there is a worldwide increase in the number of women of childbearing potential after orthotopic liver transplantation. Successful pregnancies are now increasingly being reported in these patients. These are high-risk pregnancies as increased medical and obstetric complications and adverse maternal and fetal effects of immunosuppressant medications are likely to be encountered in these patients following liver transplantation. Optimal antenatal and perioperative management in these parturients warrant a multidisciplinary approach and meticulous planning. There is little evidence available regarding anesthetic concerns in this high-risk pregnant population. This review is aimed at addressing important perioperative issues in parturients, who have undergone a successful liver transplantation.http://www.joacc.com/article.asp?issn=2249-4472;year=2014;volume=4;issue=1;spage=4;epage=11;aulast=AgarwalAnesthetic considerationsliver transplantationpregnancy post-transplant
spellingShingle Anil Agarwal
Amit Jha
Dalim Kumar Baidya
Anjan Trikha
Anesthetic considerations in parturients with liver transplant
Journal of Obstetric Anaesthesia and Critical Care
Anesthetic considerations
liver transplantation
pregnancy post-transplant
title Anesthetic considerations in parturients with liver transplant
title_full Anesthetic considerations in parturients with liver transplant
title_fullStr Anesthetic considerations in parturients with liver transplant
title_full_unstemmed Anesthetic considerations in parturients with liver transplant
title_short Anesthetic considerations in parturients with liver transplant
title_sort anesthetic considerations in parturients with liver transplant
topic Anesthetic considerations
liver transplantation
pregnancy post-transplant
url http://www.joacc.com/article.asp?issn=2249-4472;year=2014;volume=4;issue=1;spage=4;epage=11;aulast=Agarwal
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AT dalimkumarbaidya anestheticconsiderationsinparturientswithlivertransplant
AT anjantrikha anestheticconsiderationsinparturientswithlivertransplant