Publications by authors named "Tetsuro Sakai"

92 Publications

Adult liver transplant anesthesiology practice patterns and resource utilization in the United States: Survey results from the society for the advancement of transplant anesthesia.

Clin Transplant 2021 Oct 12:e14504. Epub 2021 Oct 12.

Department of Anesthesiology, University of Colorado, Aurora, CO.

Introduction: Liver transplant anesthesiology is an evolving and expanding subspecialty, and programs have, in the past, exhibited significant variations of practice at transplant centers across the United States. In order to explore current practice patterns, the Quality & Standards Committee from the Society for the Advancement of Transplant Anesthesia (SATA) undertook a survey of liver transplant anesthesiology program directors.

Methods: Program directors were invited to participate in an online questionnaire. A total of 110 program directors were identified from the 2018 Scientific Registry of Transplant Recipients (SRTR) database. Replies were received from 65 programs (response rate of 59%).

Results: Our results indicate an increase in transplant anesthesia fellowship training and advanced training in transesophageal echocardiography (TEE). We also find that the use of intraoperative TEE and viscoelastic testing is more common. However, there has been a reduction in the use of veno-venous bypass, routine placement of pulmonary artery catheters and the intraoperative use of anti-fibrinolytics when compared to prior surveys.

Conclusion: The results show considerable heterogeneity in practice patterns across the country that continues to evolve. However, there appears to be a movement towards the adoption of specific structural and clinical practices. This article is protected by copyright. All rights reserved.
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http://dx.doi.org/10.1111/ctr.14504DOI Listing
October 2021

Certified registered nurse anesthetist and anesthesiologist assistant education programs in the United States.

Nagoya J Med Sci 2021 Aug;83(3):609-626

Department of Nurse Anesthesia, University of Pittsburgh School of Nursing, Pittsburgh, USA.

In Japan, a relative shortage of practicing anesthesiologists continues to be a national issue. To address this issue, some Japanese medical institutions have started developing curriculums to train non-physician perioperative anesthesia personnel, including nurse practitioners and perianesthesia nurses. We urgently need to establish a national standard for the education programs that train these extended non-physician anesthesia care providers. A certified registered nurse anesthetist educational program at a large academic medical center in the United States is described in detail as a reference. Highly systematic educational programs using simulation, didactics, and full clinical subspecialty rotations are ideal if not easily achievable in many current training institutions in Japan. Anesthesia assistant education programs in the United States can be used as an additional reference to create a national educational program in Japan.
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http://dx.doi.org/10.18999/nagjms.83.3.609DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8437993PMC
August 2021

Abdominal Organ Transplantation: Noteworthy Literature in 2020.

Semin Cardiothorac Vasc Anesth 2021 Jun 13;25(2):138-150. Epub 2021 Apr 13.

University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

In 2020, we identified and screened over 490 peer-reviewed publications on pancreatic transplantation, over 500 on intestinal transplantation, and over 5000 on kidney transplantation. The liver transplantation section specially focused on clinical trials and systematic reviews published in 2020 and featured selected articles. This review highlights noteworthy literature pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. We explore a wide range of topics, including COVID-19 and organ transplantation, risk factors and outcomes, pain management, artificial intelligence, robotic donor surgery, and machine perfusion.
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http://dx.doi.org/10.1177/10892532211007256DOI Listing
June 2021

The Society for the Advancement of Transplant Anesthesia (SATA) enters a new partnership with Clinical Transplantation.

Clin Transplant 2021 02 21;35(2):e14203. Epub 2021 Jan 21.

Department of Anesthesiology and Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, FL, USA.

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http://dx.doi.org/10.1111/ctr.14203DOI Listing
February 2021

Viscoelastic testing in liver transplantation.

Authors:
Tetsuro Sakai

Transfusion 2020 10;60 Suppl 6:S61-S69

Department of Anesthesiology and Perioperative Medicine, UPMC (University of Pittsburgh Medical Center), Pittsburgh, Pennsylvania, USA.

Despite the lack of large randomized clinical studies, viscoelastic tests (VETs) have been a critical armamentarium for hemostatic control in liver transplantation (LT) since the 1960s. Many transplant institutions have adopted VETs in their clinical practice. Several small-size randomized clinical trials on LT patients have suggested that VET-guided hemostatic treatment algorithms have led to decreased indications for and amounts of transfused blood products, especially fresh-frozen plasma, compared to standard laboratory-based hemostatic management. VETs have also been reported to offer insight into the diagnosis and prediction of LT patients' development of hypercoagulability-related morbidity and mortality. There is still a need for VET device-specific hemostatic algorithms in LT, and clinicians must take into account the tendency to underestimate the coagulation capacity of VETs in patients with end-stage liver disease where hemostasis is rebalanced.
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http://dx.doi.org/10.1111/trf.16077DOI Listing
October 2020

Demystifying research in medical education: a novel framework, resources, and ethical challenges.

Int Anesthesiol Clin 2020 ;58(4):46-51

Department of Anesthesiology and Perioperative Medicine, the Clinical & Translational Science Institute (CTSI), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

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http://dx.doi.org/10.1097/AIA.0000000000000289DOI Listing
July 2021

Wellness Principles Correlate With More Favorable Burnout Scores in Junior Anesthesiology Residents.

J Educ Perioper Med 2020 Jan-Mar;22(1):E636. Epub 2020 Jan 1.

Background: Strategies to prevent or reduce burnout for anesthesiology residents remain relatively unexplored. We aimed to determine if participation in a wellness course would be associated with lower burnout.

Methods: A prospective, case-control survey/questionnaire study was implemented within a single anesthesiology residency in a large academic medical center program. One class participated in an inaugural wellness course (n = 15) promoting particular wellness principles 4 months into their postgraduate year (PGY)-1, while another class with no course participation served as controls (n = 13). Both groups completed the Maslach Burnout Inventory (MBI) 6 months into their PGY-2 year. In addition, a survey measuring their perceived ability to implement wellness principles (regardless of course participation) as well as validated questionnaires measuring stress, depression, and sleep quality were administered.

Results: Course participants had a trend toward lower MBI depersonalization scores; however, this was not statistically significant (MBI score 7 versus 12, P = .078, Cohen d 0.71). In a multivariable model, course participation yielded lower exhaustion scores (P = .011) whereas higher stress yielded higher exhaustion scores (P = .013), and higher depression scores yielded higher depersonalization scores (P = .019). A higher perceived ability to implement the wellness principles resulted in significantly better scores in all 3 burnout components (exhaustion P = .049, depersonalization P = .004 achievement P = .001).

Conclusion: Residents who felt they could implement wellness principles had lower burnout, regardless of course participation. Our brief course exposure had only marginal independent effects, suggesting that more longitudinal and repeated exposures to wellness training are likely required to produce a more effective outcome for mitigating burnout.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7219025PMC
January 2020

Abdominal Organ Transplantation: Noteworthy Literature in 2019.

Semin Cardiothorac Vasc Anesth 2020 Jun 28;24(2):159-174. Epub 2020 Apr 28.

University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

In the year 2019, we identified and screened over 400 peer-reviewed publications on pancreatic transplantation, over 200 on intestinal transplantation, and over 1900 on kidney transplantation. The liver transplantation section focuses on and features selected articles among 70 clinical trials published in 2019. This review highlights noteworthy literature pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. We explore a broad range of topics, including risks for and prediction of perioperative complications, updated indications for transplantation, recommendations on perioperative management, including Enhanced Recovery After Surgery programs, and topics relevant to optimization of patient and graft outcomes and survival.
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http://dx.doi.org/10.1177/1089253220920497DOI Listing
June 2020

Economic considerations in abdominal transplantation.

Best Pract Res Clin Anaesthesiol 2020 Mar 22;34(1):15-23. Epub 2020 Jan 22.

Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address:

Care for end-stage organ failure through transplant is one of the landmark accomplishments of the modern medicine. At the same time, organ transplant is a resource-intensive service that has been under increasing scrutiny in this era of cost containment. A detailed understanding of the economic implications of organ quality, recipient characteristics, and allocation policy is vital for the transplant professionals. Prior studies of kidney transplant economics demonstrate significant cost savings achieved by eliminating the need for long-term dialysis. However, transplant providers are experiencing higher financial costs because of changes in recipient characteristics. Liver transplantation economics are also more challenging because of organ allocation based on the severity of illness. Furthermore, the broader use of marginal organs has been demonstrated to increase costs. Novel strategies are vital to reduce the financial burden faced by the centers that perform transplantations on elevated risk patients and utilize lower quality organs.
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http://dx.doi.org/10.1016/j.bpa.2020.01.002DOI Listing
March 2020

Intraoperative Cardiac Arrest During Adult Liver Transplantation: Incidence and Risk Factor Analysis From 7 Academic Centers in the United States.

Anesth Analg 2021 01;132(1):130-139

From the Department of Anesthesiology, Perioperative and Pain Medicine, The Icahn School of Medicine at Mount Sinai, New York City, New York.

Background: Intraoperative cardiac arrest (ICA) has a reported frequency of 1 in 10,000 anesthetics but has a much higher estimated incidence in orthotopic liver transplantation (OLT). Single-center studies of ICA in OLT are limited by small sample size that prohibits multivariable regression analysis of risks.

Methods: Utilizing data from 7 academic medical centers, we performed a retrospective, observational study of 5296 adult liver transplant recipients (18-80 years old) between 2000 and 2017 to identify the rate of ICA, associated risk factors, and outcomes.

Results: ICA occurred in 196 cases (3.7% 95% confidence interval [CI], 3.2-4.2) and mortality occurred in 62 patients (1.2%). The intraoperative mortality rate was 31.6% in patients who experienced ICA. In a multivariable generalized linear mixed model, ICA was associated with body mass index (BMI) <20 (odds ratio [OR]: 2.04, 95% CI, 1.05-3.98; P = .0386), BMI ≥40 (2.16 [1.12-4.19]; P = .022), Model for End-Stage Liver Disease (MELD) score: (MELD 30-39: 1.75 [1.09-2.79], P = .02; MELD ≥40: 2.73 [1.53-4.85], P = .001), postreperfusion syndrome (PRS) (3.83 [2.75-5.34], P < .001), living donors (2.13 [1.16-3.89], P = .014), and reoperation (1.87 [1.13-3.11], P = .015). Overall 30-day and 1-year mortality were 4.18% and 11.0%, respectively. After ICA, 30-day and 1-year mortality were 43.9% and 52%, respectively, compared to 2.6% and 9.3% without ICA.

Conclusions: We established a 3.7% incidence of ICA and a 1.2% incidence of intraoperative mortality in liver transplantation and confirmed previously identified risk factors for ICA including BMI, MELD score, PRS, and reoperation and identified new risk factors including living donor and length of surgery in this multicenter retrospective cohort. ICA, while rare, is associated with high intraoperative mortality, and future research must focus on therapy to reduce the incidence of ICA.
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http://dx.doi.org/10.1213/ANE.0000000000004734DOI Listing
January 2021

Service Requirements of Liver Transplant Anesthesia Teams: Society for the Advancement of Transplant Anesthesia Recommendations.

Liver Transpl 2020 04 10;26(4):582-590. Epub 2020 Mar 10.

Department of Anesthesiology, University of Colorado, Aurora, CO.

There are disparities in liver transplant anesthesia team (LTAT) care across the United States. However, no policies address essential resources for liver transplant anesthesia services similar to other specialists. In response, the Society for the Advancement of Transplant Anesthesia appointed a task force to develop national recommendations. The Conditions of Transplant Center Participation were adapted to anesthesia team care and used to develop Delphi statements. A Delphi panel was put together by enlisting 21 experts from the fields of liver transplant anesthesiology and surgery, hepatology, critical care, and transplant nursing. Each panelist rated their agreement with and the importance of 17 statements. Strong support for the necessity and importance of 13 final items were as follows: resources, including preprocedure anesthesia assessment, advanced monitoring, immediate availability of consultants, and the presence of a documented expert in liver transplant anesthesia credentialed at the site of practice; call coverage, including schedules to assure uninterrupted coverage and methods to communicate availability; and characteristics of the team, including membership criteria, credentials at the site of practice, and identification of who supervises patient care. Unstructured comments identified competing time obligations for anesthesia and transplant services as the principle reason that the remaining recommendations to attend integrative patient selection and quality review committees were reduced to a suggestion rather than being a requirement. This has important consequences because deficits in team integration cause higher failure rates in service quality, timeliness, and efficiency. Solutions are needed that remove the time-related financial constraints of competing service requirements for anesthesiologists. In conclusion, using a modified Delphi technique, 13 recommendations for the structure of LTATs were agreed upon by a multidisciplinary group of experts.
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http://dx.doi.org/10.1002/lt.25711DOI Listing
April 2020

Nonopioid Modalities for Acute Postoperative Pain in Abdominal Transplant Recipients.

Transplantation 2020 04;104(4):694-699

Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.

The field of abdominal organ transplantation is multifaceted, with the clinician balancing recipient comorbidities, risks of the surgical procedure, and the pathophysiology of immunosuppression to ensure optimal outcomes. An underappreciated element throughout this process is acute pain management related to the surgical procedure. As the opioid epidemic continues to grow with increasing numbers of transplant candidates on opioids as well the increase in the development of enhanced recovery after surgery protocols, there is a need for greater focus on optimal postoperative pain control to minimize opioid use and improve outcomes. This review will summarize the physiology of acute pain in transplant recipients, assess the impact of opioid use on post-transplant outcomes, present evidence supporting nonopioid analgesia in transplant surgery, and briefly address the perioperative approach to the pretransplant recipient on opioids.
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http://dx.doi.org/10.1097/TP.0000000000003053DOI Listing
April 2020

Comparison between thromboelastography and thromboelastometry.

Authors:
Tetsuro Sakai

Minerva Anestesiol 2019 12 14;85(12):1346-1356. Epub 2019 Oct 14.

Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, USA -

Two of the most commonly used viscoelastic hemostatic assays, thromboelastometry (ROTEM) and thrombelastography (TEG), have proven to decrease allogenic blood transfusions with cost reduction and possibly decrease mortality and morbidity in cardiac, trauma, and other bleeding patients. This article compares the two devices to provide guidance on the selection and use of these monitoring systems. Their second-generation assays, TEG 6S and ROTEM Sigma, are also discussed.
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http://dx.doi.org/10.23736/S0375-9393.19.13687-5DOI Listing
December 2019

Abdominal Organ Transplantation: Noteworthy Literature in 2018.

Semin Cardiothorac Vasc Anesth 2019 Jun;23(2):188-204

2 University of Pittsburgh Medical Center Health System, PA, USA.

A PubMed search revealed 1382 articles on pancreatic transplantation, 781 on intestinal transplantation, more than 7200 on kidney transplantation, and more than 5500 on liver transplantation published between January 1, 2018, and December 31, 2018. After narrowing the list down to human studies, 436 pancreatic, 302 intestinal, 1920 liver, and more than 2000 kidney transplantation studies were screened for inclusion in this review.
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http://dx.doi.org/10.1177/1089253219842655DOI Listing
June 2019

Patient blood management: a call to anesthesiologists for leadership.

Minerva Anestesiol 2019 06 3;85(6):577-579. Epub 2019 Apr 3.

Transplant Anesthesia and Critical Care, University Hospital of Pisa, Pisa, Italy.

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http://dx.doi.org/10.23736/S0375-9393.19.13700-5DOI Listing
June 2019

An Update in Abdominal Organ Transplantation Anesthesia in 2018: Society for the Advancement of Transplant Anesthesia (SATA).

Semin Cardiothorac Vasc Anesth 2018 06;22(2):109-110

4 University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

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http://dx.doi.org/10.1177/1089253218768558DOI Listing
June 2018

The role of simulation training in anesthesiology resident education.

J Anesth 2018 06 9;32(3):425-433. Epub 2018 Mar 9.

Department of Anesthesiology, UPMC (University of Pittsburgh Medical Center), UPMC Montefiore, 200 Lothrop Street, Pittsburgh, PA, 15213, USA.

An increasing number of reports indicate the efficacy of simulation training in anesthesiology resident education. Simulation education helps learners to acquire clinical skills in a safe learning environment without putting real patients at risk. This useful tool allows anesthesiology residents to obtain medical knowledge and both technical and non-technical skills. For faculty members, simulation-based settings provide the valuable opportunity to evaluate residents' performance in scenarios including airway management and regional, cardiac, and obstetric anesthesiology. However, it is still unclear what types of simulators should be used or how to incorporate simulation education effectively into education curriculums. Whether simulation training improves patient outcomes has not been fully determined. The goal of this review is to provide an overview of the status of simulation in anesthesiology resident education, encourage more anesthesiologists to get involved in simulation education to propagate its influence, and stimulate future research directed toward improving resident education and patient outcomes.
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http://dx.doi.org/10.1007/s00540-018-2483-yDOI Listing
June 2018

Critical Importance of Low-Dose Tissue Plasminogen Activator Policy for Treating Intraoperative Pulmonary Thromboembolism During Liver Transplantation.

Semin Cardiothorac Vasc Anesth 2018 Dec 28;22(4):376-382. Epub 2018 Feb 28.

1 Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Tissue plasminogen activator (tPA) has been reported to treat intraoperative pulmonary thromboembolism (PTE) during liver transplantation (LT). However, tPA administration is often delayed due to fear of uncontrolled bleeding and storage in a refrigerator outside of operating rooms. Various dosages of tPA were used. We hypothesize that a policy of tPA storage and low dosage use improves patient outcomes. At a transplantation center, a multidisciplinary committee has implemented a tPA policy since April 2014, which includes the following: (1) timely administering of low-dose tPA (0.5-4 mg) for intraoperative PTE; (2) keeping 2 vials of tPA (2 mg/vial) in the operating room at room temperature; and (3) transferring unused tPA vials to the cardiology catheterization laboratory for next-day use. A prospective observational study was conducted to record the incidence and outcome of PTE during LTs. Over the next 19 months, 99 adult deceased donor LTs were performed with 1 (1.0%) intraoperative PTE. A 45-year-old woman with hepatitis C developed PTE within 5 minutes after graft reperfusion. A 2-mg tPA was immediately administered via a central venous line with hemodynamic improvement and clot lysis. Thromboelastography was normalized in 90 minutes. Five LT cases developing intraoperative PTE have been reported to receive "standard" dosages of tPA (20-110 mg) or urokinase (4400 IU/kg), which were administered more than 20 minutes after the diagnosis of PTE. One intraoperative death and one later mortality were noted with intracranial hemorrhages/infarction of 3 cases. The multidisciplinary low-dose tPA policy for PTE was suggested to be effective.
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http://dx.doi.org/10.1177/1089253218760221DOI Listing
December 2018

Noteworthy Literature published in 2017 for Abdominal Organ Transplantation.

Semin Cardiothorac Vasc Anesth 2018 Mar;22(1):67-80

2 University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

In 2017, we identified more than 400 peer reviewed publications on the topic of pancreas transplantation, more than 500 on intestinal transplantation, more than 4000 on renal transplantation, and more than 4700 on liver transplantation. This annual review highlights the most pertinent literature for anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. We explore a wide range of topics, including risk for and prediction of perioperative complications, recommendations on perioperative management, economic analyses, and education of the trainees in abdominal transplantation anesthesia and critical care.
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http://dx.doi.org/10.1177/1089253217753399DOI Listing
March 2018

Viscoelastic Monitoring to Guide Hemostatic Resuscitation in Liver Transplantation Surgery.

Semin Cardiothorac Vasc Anesth 2018 Jun 3;22(2):150-163. Epub 2017 Nov 3.

2 University of Pittsburgh Medical Center Health System, Pittsburgh, PA, USA.

Coagulopathic bleeding must be anticipated during liver transplantation (LT) surgery. Patients with end-stage liver disease (ESLD) often present with disease-related hematologic disturbances, including the loss of hepatic procoagulant and anticoagulant clotting factors and thrombocytopenia. Transplantation surgery itself presents additional hemostatic changes, including hyperfibrinolysis. Viscoelastic monitoring (VEM) is often used to provide targeted, personalized hemostatic therapies for complex bleeding states including cardiac surgery and major trauma. The use in these coagulopathic conditions led to its application to LT, although the mechanisms of coagulopathy in these patients are quite different. While VEM is often used during transplant surgeries in Europe and North America, evidence supporting its use is limited to a few small clinical studies. The theoretical and clinical applications of the standard and specialized VEM assays are discussed in the setting of LT and ESLD.
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http://dx.doi.org/10.1177/1089253217739121DOI Listing
June 2018

Advancing the Scientific and Educational Basis of Perioperative Cardiothoracic and Transplant Care.

Semin Cardiothorac Vasc Anesth 2017 12;21(4):273-276

4 Vanderbilt University Medical Center, Nashville, TN, USA.

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http://dx.doi.org/10.1177/1089253217738398DOI Listing
December 2017

Reduced Requirement for Prothrombin Complex Concentrate for the Restoration of Thrombin Generation in Plasma From Liver Transplant Recipients.

Anesth Analg 2017 08;125(2):609-615

From the *Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and †Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland.

Background: Plasma transfusion remains the mainstay hemostatic therapy during liver transplantation (LT) in most countries. However, a large volume is required for plasma to achieve clinically relevant factor increases. Prothrombin complex concentrate (PCC) is a low-volume alternative to plasma in warfarin reversal, but its efficacy has not been well studied in LT.

Methods: Blood samples were collected from 28 LT patients at baseline (T0) and 30 minutes after graft reperfusion (T1). Factor X and antithrombin levels were measured. Ex vivo effects of PCC (0.2 and 0.4 IU/mL) and 10% volume replacement with normal plasma were compared in LT and warfarin plasma by measuring lag time, thrombin peak, and endogenous thrombin potential (ETP) using thrombin generation (TG) assay.

Results: Coagulation status was worsened at T1 as international normalized ratio increased from 1.7 to 3.0, and factor X was decreased from 49% to 28%. TG measurements showed normal lag time and ETP at T0 and T1, but low-normal peak at T0, and below-normal peak at T1. Both doses of PCC increased peak and ETP, while 10% volume plasma had minimal effects on TG. Thrombin inhibition appears to be very slow after adding 0.4 IU/mL of PCC in LT plasma due to low antithrombin. The same doses of PCC and plasma were insufficient for warfarin reversal.

Conclusions: Reduced TG in LT can be more effectively restored by using PCC rather than plasma. The required doses of PCC for LT patients seem to be lower than warfarin reversal due to slow thrombin inhibition.
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http://dx.doi.org/10.1213/ANE.0000000000002106DOI Listing
August 2017

Update on Finger-Application-Type Noninvasive Continuous Hemodynamic Monitors (CNAP and ccNexfin): Physical Principles, Validation, and Clinical Use.

Semin Cardiothorac Vasc Anesth 2017 Dec 10;21(4):321-329. Epub 2017 May 10.

1 University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

The CNAP HD Monitor (CNSystems, Graz, Austria) and the ccNexfin (The ClearSight System: Edwards Lifesciences Corporation, Irvine, CA) are continuous, noninvasive blood pressure monitors using a finger-application device. These devices show a promising ability to allow for rapid detection of hemodynamic derangement when compared with oscillometry. The accuracy and precision of these devices as blood pressure monitors has been evaluated when compared with intra-arterial catheters. Additionally, they can be used to measure beat-to-beat cardiac output (CO). As CO monitors, they are capable of trending changes in CO when compared with a transpulmonary thermodilution monitor. Difficulty with use in critically ill and awake patients has been encountered because of altered microvascular physiology and patient movement. The principles of operation and clinical validation of these devices are presented. The clinicians who are interested in using these devices in their clinical setting should be aware of the relatively large bias and CIs in the hemodynamic measurements.
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http://dx.doi.org/10.1177/1089253217708620DOI Listing
December 2017

The Society for the Advancement of Transplant Anesthesia (SATA).

Semin Cardiothorac Vasc Anesth 2017 Mar 20;21(1). Epub 2017 Jan 20.

4 University of Colorado, Aurora, CO, USA.

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http://dx.doi.org/10.1177/1089253216688540DOI Listing
March 2017

Noteworthy Literature Published in 2016 for Abdominal Organ Transplant Anesthesiologists.

Semin Cardiothorac Vasc Anesth 2017 Mar 20;21(1):70-80. Epub 2017 Jan 20.

2 University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

More than 400 peer-reviewed publications on the topic of pancreas transplantation, more than 400 on intestine transplantation, and more than 3000 on renal transplantation were published in 2016. This review will highlight the most pertinent literature for anesthesiologists caring for patients undergoing non-liver abdominal organ transplantation. This review is the second part in an annual series to review relevant contributions in the field of abdominal organ transplantation focusing on pancreas, intestine, and renal transplantation. We explore a myriad of topics, including outcomes determined by center size, novel assessment of intestine graft function, the effect of Zika virus on the transplant population, appropriate fluid management for renal transplantation, cardiovascular risk assessment in the transplant population, and several topics pertinent to optimizing patient and graft survival.
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http://dx.doi.org/10.1177/1089253216688538DOI Listing
March 2017

Noteworthy Literature Published in 2016 for Abdominal Organ Transplantation Anesthesiologists.

Semin Cardiothorac Vasc Anesth 2017 Mar 18;21(1):58-69. Epub 2017 Jan 18.

2 Icahn School of Medicine at Mount Sinai, New York, NY, USA.

More than 3000 peer-reviewed publications on the topic of liver transplantation were published in 2016. The goal of this article is to provide a concise review of pertinent literature for anesthesiologists who participate in liver transplantation. The authors selected and presented 33 articles published in 2016 on the topics of MELD policy; cardiovascular, pulmonary, and renal issues; coagulation and transfusion; anesthetic agents; hemodynamic monitors; acute liver failure; and donor issues.
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http://dx.doi.org/10.1177/1089253216688536DOI Listing
March 2017

[Differences between Anesthesiology Residency Education Programs in Japan and the USA].

Masui 2017 01;66(1):88-93

New anesthesiology residency education program requirements were launched in Japan. The main change was to specify which anesthesia cases a resi- dent must experience during the training period. We believe that comparing the educational requirements between anesthesiology specialty certification programs in Japan and the USA is a timely undertaking. This detailed comparison study is aimed to identify compo- nents to improve the current educational systems in each country. Three educational components are required in the USA, but not in Japan: daily clinical evaluations based on well-defined criteria, regular lectures and nation- wide annual achievement tests, and national board- accredited subspecialty fellowships. Conversely, in Japan, scholarly presentations at scientific meetings are mandatory for anesthesiology board certification, but the scholarly activity requirement in the USA is vaguely defined. These points identified through our comparison could help improve residency training programs in both Japan and in the USA.
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January 2017
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