Transoesophageal echocardiography during liver transplantation

作     者：Lesley De Pietri Federico Mocchegiani Chiara Leuzzi Roberto Montalti Marco Vivarelli Vanni Agnoletti 

作者机构：Division of Anaesthesiology and Intensive Care Unit Azienda Ospedaliero-Universitaria di Modena-Policlinico Transplantation Unit Polytechnic University of Marche Unit of Interventional Cardiology Arcispedale Santa Maria Nuova IRCCS Division of Anaesthesiology and Intensive Care Unit Arcispedale Santa Maria Nuova IRCCS 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2015年第7卷第23期

页      面：2432-2448页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Liver transplantation Transoesophageal echocardiog 

摘      要：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 trans-plant 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 pro-cedures 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. More-over, 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.