Anaesthesia for liver transplantation in cystic fibrosis patients

G. Della Rocca, L. Pompei, F. Pugliese, C. Coccia, F. Ruberto, C. Montecchi, M. Antonini, M. Rossi, D. Alfani, R. Cortesini, A. Gasparetto

Research output: Contribution to journalArticle

Abstract

Introduction: Cystic fibrosis (CF) is a disease caused by an inherited genetic defect. While pulmonary and pancreatic abnormalities predominate the clinical spectrum, other organ involvement is common, including liver. The severity of liver disease does not appear to be related to the severity of exocrine pancreatic or lung function. We discuss anaesthesia in four CF patients undergoing liver transplantation. Methods: We studied haemodynamic and oxygenation modifications during anaesthesia in four patients affected by CF with end-stage liver disease and mild to moderate pulmonary abnormalities. The patients received pancreatic enzyme prior to transplantation and two had insulin-dependent diabetes mellitus. All patients were treated with broadspectrum antibiotic therapy. After a waiting time ranging one week to three months, all patients were successfully transplanted. General anaesthesia was induced with fentanyl, thiopental and pancuronium, and maintained with isoflurane supplemented by fentanyl in O2:air. Haemodynamic and oxygenation evaluations were made during the main phases of the transplant. After the intubation and at the end of the procedure all patients received a broncho-alveolar toilet through fiberoptic bronchoscopy. Results: During anaesthesia for liver transplantation, PaO2 increased proportionally to the decreasing of Qs/Qt. In postoperative follow-up, Fev1 and FVC improved from preoperative time in all patients. In conclusion, even if cystic fibrosis is a multisystem disease, liver transplantation can be offered to CF patients with endstage liver disease and mild to moderate pulmonary function abnormalities. The four patients are still alive, enjoying good health. The improved respiratory function and quality of life of these children is remarkable.

Original languageEnglish
Pages (from-to)278-281
Number of pages4
JournalEuropean Journal of Pediatric Surgery
Volume8
Issue number5
Publication statusPublished - Oct 1998

Keywords

  • Anaesthesia
  • Cystic fibrosis
  • Liver transplantation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Della Rocca, G., Pompei, L., Pugliese, F., Coccia, C., Ruberto, F., Montecchi, C., Antonini, M., Rossi, M., Alfani, D., Cortesini, R., & Gasparetto, A. (1998). Anaesthesia for liver transplantation in cystic fibrosis patients. European Journal of Pediatric Surgery, 8(5), 278-281.