Multisystemic Anesthetic Management and Patient Blood Management in Urgent Liver Transplantation for Acute-on-Chronic Liver Failure: A Case Report.
Roxanne Cabral Miragaia Aquino, Gustavo Guimarães Torres, Renato Toledo Maciel et al.
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Case in brief
A 42-year-old woman with chronic cholestatic liver disease developed acute-on-chronic liver failure, necessitating urgent liver transplantation. She presented with hepatic encephalopathy, systemic infection, and hepatorenal syndrome. The surgery utilized total intravenous anesthesia and advanced monitoring. Despite severe intraoperative vasoplegia, she received no allogeneic blood products. Postoperatively, she stabilized hemodynamically, recovered renal function, and was discharged without major complications.
Diagnostic / clinical pearl
This case underscores the significance of tailored anesthetic management and strict adherence to Patient Blood Management principles in urgent liver transplantation.
Why it matters
Implementing advanced monitoring and restrictive transfusion strategies may enhance perioperative stability and improve postoperative outcomes in similar high-risk patients.