98 results match your criteria Perioperative Management of the Patient With Liver Disease


Anesthesia for the Patient with Severe Liver Failure.

Adv Anesth 2020 Dec;38:251-267

Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, 3 Eaton North, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada. Electronic address:

The incidence of liver failure continues to increase, and it is associated with increased perioperative morbidity and mortality. Liver failure is associated with multiorgan dysfunction, including central nervous, cardiac, respiratory, gastrointestinal, renal, and hematological systems. Preoperative identification, optimization, and tailored anesthetic management are essential for optimum outcomes in patients with liver disease undergoing surgery. Read More

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December 2020

Pericardiectomy for Constrictive Pericarditis: Analysis of Outcomes.

J Cardiothorac Vasc Anesth 2021 Feb 11. Epub 2021 Feb 11.

Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN. Electronic address:

Constrictive pericarditis is caused by pericardial inflammation and fibrosis, leading to diastolic heart failure. The diagnosis requires a high index of suspicion because it often can mimic restrictive myocardial disease and cardiac tamponade and can be associated with severe tricuspid regurgitation and chronic liver disease. Patients who remain undiagnosed can experience a 90% mortality rate, and for those who undergo pericardiectomy, the survival rate varies significantly, depending on the underlying etiology and preoperative functional class of the patient. Read More

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February 2021

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition).

Autophagy 2021 Jan 8;17(1):1-382. Epub 2021 Feb 8.

University of Crete, School of Medicine, Laboratory of Clinical Microbiology and Microbial Pathogenesis, Voutes, Heraklion, Crete, Greece; Foundation for Research and Technology, Institute of Molecular Biology and Biotechnology (IMBB), Heraklion, Crete, Greece.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Read More

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January 2021

A focal extramedullary hematopoiesis of the spleen in a patient with essential thrombocythemia presenting with a complicated postoperative course: a case report.

Surg Case Rep 2021 Jan 26;7(1):33. Epub 2021 Jan 26.

Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.

Background: Extramedullary hematopoiesis is a compensatory response occurring secondary to inadequate bone marrow function and is occasionally observed in essential thrombocythemia (ET). This disease usually presents as multifocal masses in the paravertebral or intra-abdominal region; however, formation of a focal mass in the liver or spleen is rare. In addition, ET is characterized by increased platelet count and shows a tendency toward thrombosis and, occasionally, bleeding. Read More

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January 2021

Surgical treatment for breast cancer in a patient with erythropoietic protoporphyria and photosensitivity: a case report.

Surg Case Rep 2021 Jan 5;7(1). Epub 2021 Jan 5.

Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Background: Erythropoietic protoporphyria (EPP) is a rare disorder of heme synthesis. Patients with EPP mainly show symptoms of photosensitivity, but approximately 20% of EPPs are associated with the liver-related complications. We report a case of breast cancer in a 48-year-old female patient with EPP in whom meticulous perioperative management was required in order to avoid complications resulting from this disease. Read More

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January 2021

Robot-Assisted Total Pancreatectomy With Autologous Islet Cell Transplantation: Perioperative Nursing Considerations.

AORN J 2020 10;112(4):353-365

Chronic pancreatitis (CP) is an inflammatory disease of the pancreas that causes pain and gastrointestinal problems in patients. Robot-assisted total pancreatectomy with autologous islet cell transplantation (TPAIT) is a surgical procedure for treating patients with CP that has been unresponsive to other treatments. After performing a total pancreatectomy, the surgical team isolates islet cells and then infuses them into the patient's liver. Read More

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October 2020

Evaluation of surgical risk in patients with liver cirrhosis.

Vnitr Lek 2020 ;66(4):253-257

The prevalence of liver cirrhosis in population is increasing, as well as its prevalence among patients admitted to hospital for elective surgery. These patients are at risk of high postoperative morbidity and mortality. Perioperative risk assessment of patients with liver cirrhosis is a complex procedure. Read More

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November 2020

Preoperative Evaluation and Anesthetic Management of Patients With Liver Cirrhosis Undergoing Cardiac Surgery.

J Cardiothorac Vasc Anesth 2020 Aug 14. Epub 2020 Aug 14.

Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA.

Preoperative evaluation and anesthetic management of patients with liver cirrhosis undergoing cardiac surgery remain a clinical challenge because of its high risk for perioperative complications. This narrative review article summarizes the pathophysiology and anesthetic implication of liver cirrhosis on each organ system. It will help physicians to evaluate surgical candidates, to optimize intraoperative management, and to anticipate complications in liver cirrhosis patients undergoing cardiac surgery. Read More

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Anesthetic considerations for combined heart--liver transplantation in patients with Fontan-associated liver disease.

Curr Opin Organ Transplant 2020 10;25(5):501-505

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Purpose Of Review: The success of the Fontan procedure has led to increased survival of patients born with certain congenital heart disease to the point that new sequlae, as a result of Fontan circulation, are being discovered. Included among these is Fontan-associated liver disease (FALD). The purpose of this review is to present available literature on the perioperative management of the combined heart--liver transplantation (CHLT) in patients with FALD. Read More

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October 2020

Bariatric Surgery in the Setting of Liver Cirrhosis with Portal Hypertension: the Confection and Particularities of Roux-en-Y Gastric Bypass in a High-Risk Patient.

Obes Surg 2020 Oct 27;30(10):4165-4166. Epub 2020 Jul 27.

Université Côte d'Azur, Nice, France.

Introduction: Morbid obesity is associated with the occurrence of non-alcoholic fatty liver disease, which may progress to cirrhosis. Although weight loss is the treatment of choice, surgical management can be challenging at the stage of cirrhosis. The aim of this video report is to present the confection and the features of a Roux-en-Y gastric bypass (RYGB) in the setting of liver cirrhosis. Read More

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October 2020

Good syndrome with cytomegalovirus hepatitis: successful resection of Thymoma: a case report.

J Cardiothorac Surg 2020 Jun 15;15(1):141. Epub 2020 Jun 15.

Division of Chest Surgery, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.

Background: Good syndrome is a rare condition, manifesting as immunodeficiency due to hypogammaglobulinemia associated with thymoma. Herein, we present a patient with Good syndrome whose thymoma was resected after treatment of cytomegalovirus hepatitis.

Case Presentation: The patient was a 45-year-old woman presenting with fever, cough, and nasal discharge, and was diagnosed with thymoma and hypogammaglobulinemia. Read More

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[A Case of Superior Mesenteric Vein Thrombosis during Administration of Bevacizumab for Rectal Cancer].

Gan To Kagaku Ryoho 2019 Dec;46(13):2491-2493

Dept. of Surgery, Japan Community Healthcare Organization(JCHO)Osaka Hospital.

A colonoscopy to investigate fecal incontinence revealed a type 3 tumor in the rectum of a 67-year-old man. Histological findings demonstrated rectal adenocarcinoma. CT revealed multiple metastases in the liver, and the patient was diagnosed as having rectal cancer(Rb, Ant, type 3, T3, N3, M1a[H2], cStage Ⅳa). Read More

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December 2019

Perioperative anesthetic management for cesarean delivery of severe Wilson's disease with liver failure: a case report.

JA Clin Rep 2019 Nov 13;5(1):75. Epub 2019 Nov 13.

Department of Anesthesiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.

Background: Wilson's disease is a rare autosomal recessive disorder affecting copper metabolism, which presents liver and brain dysfunction caused by abnormal copper accumulation. We report a patient who showed exacerbation of liver failure during pregnancy.

Case Presentation: A 24-year-old woman with Wilson's disease was scheduled for emergency cesarean delivery at 30 weeks of gestation. Read More

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November 2019

Anesthesia for the Patient with Severe Liver Failure.

Anesthesiol Clin 2020 Mar 3;38(1):35-50. Epub 2020 Jan 3.

Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, 3 Eaton North, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada. Electronic address:

The incidence of liver failure continues to increase, and it is associated with increased perioperative morbidity and mortality. Liver failure is associated with multiorgan dysfunction, including central nervous, cardiac, respiratory, gastrointestinal, renal, and hematological systems. Preoperative identification, optimization, and tailored anesthetic management are essential for optimum outcomes in patients with liver disease undergoing surgery. Read More

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Evaluation and Management of the Child and Adult With Fontan Circulation: A Scientific Statement From the American Heart Association.

Circulation 2019 Jul 1:CIR0000000000000696. Epub 2019 Jul 1.

It has been 50 years since Francis Fontan pioneered the operation that today bears his name. Initially designed for patients with tricuspid atresia, this procedure is now offered for a vast array of congenital cardiac lesions when a circulation with 2 ventricles cannot be achieved. As a result of technical advances and improvements in patient selection and perioperative management, survival has steadily increased, and it is estimated that patients operated on today may hope for a 30-year survival of >80%. Read More

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Dentistry and oral and maxillofacial surgery in the patient with liver disease: key messages for clinical practice.

Minerva Stomatol 2019 Aug 27;68(4):192-199. Epub 2019 May 27.

Unit of Gastroenterology, Molinette - San Giovanni Antica Sede Hospital, Turin, Italy -

The recent changes in terms of both epidemiology of chronic liver disease (CLD) and long-term survival of patients with CLD have had a great impact in the field of dentistry and oral and maxillofacial surgery. In this context, compared with the previous decades, today it is more probable to cure patients with CLD also at advanced stage (cirrhosis), that could remain asymptomatic for long, before the appearance of signs of decompensation. Hence, it is crucial to identify the patient with CLD and to define the stage of the latter. Read More

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Mixed neuroendocrine-non-neuroendocrine carcinoma of gallbladder: case report.

World J Surg Oncol 2019 Mar 22;17(1):55. Epub 2019 Mar 22.

Faculty of Medicine in Pilsen, Charles University, 301 00, Pilsen, Czech Republic.

Background: Mixed neuroendocrine-non-neuroendocrine tumors (MINEN) of the gallbladder are extremely rare; indeed, the English expert literature reports a mere handful of case reports and case series on this topic. According to the WHO classification of 2010, MINEN are considered to be tumors consisting of two major components, neuroendocrine and non-neuroendocrine, each of which hosts at least 30% of the total cellular population. To date, the etiology and pathogenesis of MINEN have not been precisely determined and the non-specific symptoms generally result in late diagnosis (mainly in the terminal stages of the condition) and contribute to the generally poor prognosis. Read More

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[Preconditioning of the liver].

Chirurg 2019 Jul;90(7):542-547

Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie Tübingen, Hoppe-Seylerstraße 3, 72076, Tübingen, Deutschland.

Posthepatectomy liver failure (PHLF) still represents a severe complication after major liver resection associated with a high mortality. In addition to an insufficient residual liver volume various factors play an important role in the pathophysiology of PHLF. These include the quality of the parenchyma, liver function, perfusion, i. Read More

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Persistent acidosis after reperfusion-A prognostic indicator of increased 30-day and in-hospital postoperative mortality in liver transplant recipients.

Clin Transplant 2019 03 24;33(3):e13473. Epub 2019 Jan 24.

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

During liver transplantation, the patient is at risk of developing progressive lactic acidosis. Following reperfusion, correction of acidosis may occur. In some patients, acidosis will worsen, a phenomenon referred to as persistent acidosis after reperfusion (PAAR). Read More

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Lusutrombopag (Mulpleta®) treatment in a patient with thrombocytopenia complicated by cirrhosis prior to continuous epidural anesthesia during renal artery embolization: a case report.

JA Clin Rep 2018 Nov 20;4(1):80. Epub 2018 Nov 20.

Pain Clinic and Palliative Care Medicine, Saga University Hospital, 5-1-1 Nabeshima, Saga, 849-8501, Japan.

Background: The oral thrombopoietin (TPO) receptor agonist lusutrombopag (Mulpleta®) was developed to improve thrombocytopenia in patients with chronic liver disease prior to elective invasive medical procedures. Mulpleta® was first approved for use in Japan in 2015 and in the USA in 2018. In the present report, we discuss a case in which pain management was performed during left renal artery embolization via continuous epidural anesthesia following oral administration of lusutrombopag. Read More

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November 2018

Clinical outcome of 1,000 consecutive cases of liver transplantation: a single center experience.

Ann Surg Treat Res 2018 Nov 25;95(5):267-277. Epub 2018 Oct 25.

Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Purpose: The aim of this study was to analyze survival outcomes in 1,000 consecutive liver transplantations (LTs) performed at a single institution from 1993 to April 2017.

Methods: The study population was divided into 2 groups based on donor type: deceased donor LT (DDLT; n = 181, 18.1%) and living donor LT (LDLT; n = 819; 81. Read More

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November 2018

Risk factors for hepatic insufficiency after major hepatectomy in non-cirrhotic patients.

Asian J Surg 2019 Jan 28;42(1):251-255. Epub 2018 Aug 28.

Department of Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.

Background: Although recent advances in surgical techniques and perioperative management have reduced the morbidity and mortality after hepatectomy, hepatic insufficiency after major hepatectomy remains an important concern. This study aimed to clarify the risk factors for post-hepatectomy liver insufficiency.

Methods: We enrolled 103 consecutive patients who underwent major hepatectomy which was defined as resection of four or more segments. Read More

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January 2019

Half of Postoperative Deaths After Hepatectomy may be Preventable: A Root-cause Analysis of a Prospective Multicenter Cohort Study.

Ann Surg 2018 11;268(5):792-798

Department of Digestive Surgery, Amiens, France.

Objective: To perform a retrospective root-cause analysis of the causes of postoperative mortality after hepatectomy.

Background: Mortality after liver resection has not decreased over the past decade.

Methods: The study population was a prospective cohort of hepatectomies performed at hepatic, pancreatic, and biliary (HPB) centers between October 2012 and December 2014. Read More

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November 2018

Does Induction Type Influence Outcomes in Kidney Transplant Recipients at Different Phases of Hepatitis B Infection?

Exp Clin Transplant 2019 08 31;17(4):457-460. Epub 2018 Jul 31.

From the Division of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.

Objectives: Immunosuppressive therapy in kidney transplant recipients with hepatitis B virus infection may increase the risk of disease progression. Here, we compared outcomes of depleting (antithymocyte globulin/alemtuzumab) versus nondepleting (basiliximab/daclizumab) antibody induction in kidney transplant recipients at different serologic phases of hepatitis B virus infection.

Materials And Methods: We used the Organ Procurement and Transplantation Network/United Network for Organ Sharing database to identify adult kidney transplant recipients at different serologic phases of hepatitis B virus infection (transplants received from 2001-2011 after patients received perioperative induction with discharge on calcineurin inhibitors/mycophenolate mofetil with/without steroids). Read More

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Liver transplantation in hemophilia A and von Willebrand disease type 3: perioperative management and post-transplant outcome.

Rev Esp Enferm Dig 2018 Aug;110(8):522-526

Cirugía General y del Aparato Digestivo, H.C.U. Lozano Blesa.

Introduction: infection with the hepatitis C virus (HCV) causes significant morbidity and mortality in patients with hemophilia. Finally, patients are considered for a liver transplantation (LT) due to cirrhosis and/or hepatocellular carcinoma (HCC).

Case Report: we report the cases of congenital coagulopathy and HCV infection that underwent LT in our institution. Read More

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Desmopressin Reverses Overly Rapid Serum Sodium Correction in a Hyponatremic Patient Undergoing Living Donor Liver Transplantation: A Case Report.

A A Pract 2018 Aug;11(3):82-84

From the Department of Anesthesia and Perioperative Care, University of California, San Francisco, California.

Patients with end-stage liver disease are often hyponatremic due to multiple physiological processes associated with hepatic failure. For severely hyponatremic patients undergoing liver transplantation, intraoperative management of serum sodium concentration ([Na]s) is challenging. [Na]s tends to increase during transplantation by the administration of fluids with higher sodium concentration than the patient's [Na]s. Read More

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Analgesic Effects of Oxycodone Relative to Those of Sufentanil, in the Presence of Midazolam, During Endoscopic Injection Sclerotherapy for Patients With Cirrhosis and Esophageal Varices.

Anesth Analg 2018 08;127(2):382-386

From the Department of Anesthesiology, Beijing Youan Hospital, Capital Medical University, Beijing, China.

Background: We evaluated the efficacy and gastroenterologist/patient satisfaction of midazolam combined with oxycodone, relative to that of midazolam combined with sufentanil, for anesthesia during endoscopic injection sclerotherapy (EIS) in patients with cirrhosis and esophageal varices.

Methods: Patients with cirrhosis (20-69 years of age), body mass index, 18-25 kg/m, American Society of Anesthesiology patient classification physical status I-II who underwent elective EIS were randomly assigned to 1 of 2 groups. In this prospective, double-blinded, randomized controlled trial, 1 group received midazolam and oxycodone (n = 64), and the other group received midazolam and sufentanil (n = 63). Read More

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Perioperative management with phosphodiesterase type 5 inhibitor and prostaglandin E1 for moderate portopulmonary hypertension following adult-to-adult living-donor liver transplantation: a case report.

Surg Case Rep 2018 Feb 7;4(1):15. Epub 2018 Feb 7.

Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-0037, Japan.

Background: Portopulmonary hypertension (PPH) is a relatively rare but well-recognized complication of end-stage liver disease. Moderate or severe PPH (mean pulmonary artery pressure [mPAP] ≥ 35 mmHg) is usually a contraindication for liver transplantation due to high operation-related mortality. Here, we report on a patient with moderate PPH whose condition was successfully managed with a phosphodiesterase type 5 (PDE5) inhibitor (tadalafil) and prostaglandin E1, who experienced rapid improvement of PPH after living-donor liver transplantation (LDLT). Read More

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February 2018

[Simultaneous Hepatorenal Transplantation from a Brain-Dead Donor for Graft Dysfunction and Renal Insufficiency in a Liver Transplant Recipient : A Case Report].

Hinyokika Kiyo 2017 Aug;63(8):313-318

The Department of Urology, Kyoto University Hospital.

We report a case of lethal hepatorenal insufficiency in a 52-year-old man who received successful simultaneous hepatorenal transplantation from a deceased donor. The patient had undergone live-donor liver transplantation for type-C hepatitis and liver cirrhosis 11 years before he developed graft liver dysfunction due to recurrent viral hepatitis and cirrhosis. At that instance, he also developed end-stage renal dysfunction due to calcineurin inhibitor nephropathy and hepatorenal syndrome. Read More

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Successful Blood Transfusion Management of a Living Donor Liver Transplant Recipient in the Presence of Anti-Jr: A Case Report.

Transplant Proc 2017 Sep;49(7):1604-1607

Department of Transplantation Surgery, Nagoya University Hospital, Nagoya, Aichi, Japan. Electronic address:

A 48-year-old Japanese woman was diagnosed with Budd-Chiari syndrome and transferred for possible living donor liver transplantation (LDLT). Examinations before LDLT revealed that the recipient had anti-Jr and preformed donor-specific anti-human leukocyte antigen (HLA) antibodies (DSA). Rituximab was administrated at 16 days prior to the patient's scheduled LDLT for the prophylaxis of antibody-mediated rejection by DSA. Read More

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September 2017