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CASE REPORT
Year : 2013  |  Volume : 57  |  Issue : 6  |  Page : 599-602

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


1 Department of Anaesthesia and Pain Medicine, Liver Transplant Anaesthesia and Critical Care, Fortis Hospital, Noida, Uttar Pradesh, India
2 Department of Liver Transplant and GI Surgery, Fortis Hospital, Noida, Uttar Pradesh, India

Correspondence Address:
Lalit Sehgal
Liver Transplant Anaesthesia and Critical Care, Room No: 2153, Fortis Hospital, B-22, Sector 62, Noida, Uttar Pradesh - 201 301
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5049.123335

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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.


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