Perioperative management of liver transplantation with concurrent coronary artery disease: Report of two cases

• Main Authors: Piyush Srivastava, Lalit Sehgal, Nalin Sharma, Anil Agrawal, Vivek Vij
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2013-01-01
• Series: Indian Journal of Anaesthesia
• Subjects: Coronary artery disease; liver transplantation; post reperfusion syndrome
• Online Access: http://www.ijaweb.org/article.asp?issn=0019-5049;year=2013;volume=57;issue=6;spage=599;epage=602;aulast=Srivastava

Coronary artery disease (CAD), even if asymptomatic, has been known to complicate the perioperative management of patients undergoing liver transplantation. Perioperative outcome for such patients is worse than those without CAD despite improvement in risk stratification and management of CAD. We hereby report the successful perioperative management of two patients with CAD undergoing living-related liver transplantation. Maintaining systemic vascular resistance, goal-directed volume administration and surgical technique avoiding total clamping of IVC was the mainstay of stable intraoperative course. Moreover, a lower model for end stage liver disease (MELD) score at the time of liver transplant may also have been contributory to successful outcome in our patients.