Includes Index

Liver transplantation and liver surgery have made enormous strides in the last
20 years. It has been transformed from an often heroic operation requiring
massive amounts of blood transfusions to almost routine surgery with little
blood loss in spite of increasing recipient morbidity. This advancement is
re fl ected in improved long-term mortality rates in the face of preferentially
allocating more marginal organs to sicker recipients.
Many little steps and advances are responsible for this achievement, not
least improvements of anesthetic techniques and postoperative care. These
little steps may not be immediately obvious but were necessary to accomplish
such a progress. Clinical and preclinical research in liver anesthesiology and
critical care medicine in the last 10 years has thrived, and a new generation of
anesthesiologists and intensive care physicians are willing to scrutinize their
clinical practice using clinical research tools instead of relying only on experience. This has created a fascinating and productive interaction within the
small group of anesthesiologists and intensivists who care for these severely
sick patients.
This book summarizes their current knowledge by bringing together the
leading experts of our sub-specialty. It not only condenses a large amount of
clinical research but also includes opinions and experiences when evidence is
insuf fi cient.
It is an in-depth review of the fi eld and presents the current best knowledge. It aims to be the de fi nitive resource of liver anesthesiology and critical
care medicine. Experienced and busy practitioners will fi nd essential information to manage complex conditions of liver disease. The novice anesthesiologist or resident will be able to use this book as a thorough and comprehensive
introduction to our fi eld and rapidly gain extensive knowledge as well as
obtain practical advice for those complex and scary situations that can occur
so frequently during liver transplantation.
This book provides a comprehensive review of the pathophysiology of liver
disease, pharmacology, immunology, and its implications for the anesthesiologist and intensivist. Anesthesiologic and postoperative care of liver transplant recipients requires a thorough appreciation of the intricacies of liver
disease and its complications. Extra-hepatic manifestations of liver disease
are addressed in chapters separated by organ systems. Routine management as well as common intra- and postoperative complications are described in detail
to provide the knowledge required to care for these patients.
Liver transplantation is expanding internationally and a large body of work
and experience originates from centers in Europe and Asia. Experts from the
United States, Europe, and Asia have contributed to this book to give a global
perspective of liver transplant anesthesiology.
A separate section reviews the anesthetic and postoperative management
of patients undergoing liver resection. New surgical approaches have
allowed us to perform more extensive and intricate resections that pose new
challenges to the anesthesiologist and intensivists. Surgical techniques and
their physiologic repercussions are described in detail and management
strategies for routine as well as complex cases and their possible complications are offered.
We hope this book will alleviate the apprehension often associated with
caring for these sick patients and encourage many readers to engage in liver
anesthesiology and critical care medicine.