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Korean Journal of Anesthesiology 2007;53(4):547-553.
DOI: https://doi.org/10.4097/kjae.2007.53.4.547   
Anesthesia for Liver Transplantation in a Patient with Hepatic Failure Combined with Primary Renal Failure: A case report.
Duk Kyung Kim, Hae Kyoung Kim, Tae Yop Kim, Jeong Ae Lim, Yang Lyoul Kim, Sung Whan Jang
1Departments of Anesthesiology and Pain Medicine, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea. dikei@kuh.ac.kr
2Department of Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea.
Renal failure frequently accompanies advanced hepatic failure. Even if adequate renal function is not considered as a prerequisite for transplant candidacy, impaired renal function prior to liver transplantation has been regarded as an independent risk factor of graft dysfunction and mortality. Liver transplantation in such a patient also presents a number of challenges to the anesthesiologists. Optimal fluid therapy, prompt and aggressive correction of electrolytes and metabolic disturbances, careful selection of anesthetic techniques and agents, and close monitoring of cardio-respiratory function help reduce the graft failure and perioperative mortality. In such cases, continuous renal replacement therapy (CRRT) is used with increasing frequency during or after the surgery. So, anesthesiologists need to understand the basic principles, potential applications, and anesthetic implications of several CRRT options. We therefore present the anesthetic experience in a patient with hepatic failure combined with primary renal failure, successfully managed during or after liver transplantation.
Key Words: continuous renal replacement therapy; liver transplantation; renal failure


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