Transoesophageal echocardiography during liver transplantation

Lesley De Pietri, Federico Mocchegiani, Chiara Leuzzi, Roberto Montalti, Marco Vivarelli, Vanni Agnoletti

Research output: Contribution to journalArticlepeer-review

Abstract

Liver transplantation (LT) has become the standard of care for patients with end stage liver disease. The allocation of organs, which prioritizes the sickest patients, has made the management of liver transplant candidates more complex both as regards their comorbidities and their higher risk of perioperative complications. Patients undergoing LT frequently display considerable physiological changes during the procedures as a result of both the disease process and the surgery. Transoesophageal echocardiography (TEE), which visualizes dynamic cardiac function and overall contractility, has become essential for perioperative LT management and can optimize the anaesthetic management of these highly complex patients. Moreover, TEE can provide useful information on volume status and the adequacy of therapeutic interventions and can diagnose early intraoperative complications, such as the embolization of large vessels or development of pulmonary hypertension. In this review, directed at clinicians who manage TEE during LT, we show why the procedure merits a place in challenging anaesthetic environment and how it can provide essential information in the perioperative management of compromised patients undergoing this very complex surgical procedure.

Original languageEnglish
Pages (from-to)2432-2448
Number of pages17
JournalWorld Journal of Hepatology
Volume7
Issue number23
DOIs
Publication statusPublished - 2015
Externally publishedYes

Keywords

  • Cirrhotic cardiomyopathy
  • Liver cirrhosis
  • Liver transplantation
  • Perioperative anaesthesia management
  • Transoesophageal echocardiography

ASJC Scopus subject areas

  • Hepatology

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