[Anesthesiologic management of clinical orthotopic liver transplantation]. / Anesteziologicheskoe obespechenie ortotopicheskoi transplantatsii pecheni v klinike.

The first clinical experience of anesthesiological management during 6 orthotopic liver transplantations (5 primary operations and 1 retransplantation) in 2 males and 3 females, aged 20 to 52 years, is presented. The method of general anesthesia is described--the use of veno-venous bypass without systemic heparinization and rapid infusion system. Hemodynamic, temperature, metabolic and coagulologic homeostasis disturbances are analysed at different stages of orthotopic liver transplantation, especially upon reperfusion of the donor organ. The tactics of infusion-transfusion therapy, as well as correction of electrolyte disturbances and blood coagulation disorders are being discussed. Different intraoperative complications are characterized. It is concluded that anesthesiological management of liver transplantations is one of the most complex problems of modern anesthesiology which takes joint effort of a large team of specialists: surgeons, anesthesiologists, perfusiologists, transfusiologists, and laboratory assistants specializing in different areas.

[General anesthesia in non-cardiac surgery in patients with transplanted hearts]. / Obshchaia anesteziia pri nekardiokhirurgicheskikh vmeshatel'stvakh u bol'nykh s transplantirovannym serdtsem.

At present non-cardiac surgery is infrequent in patients survived after heart transplantations. The authors review specific features of general anesthesia in such a clinical situation on the basis of their own two clinical observations and literature data. The principles for the anesthesiological management are analysed. They are specific sterility rules, atypical mechanisms of cardio-vascular system adaptation to stress and peculiar reaction of a denervated heart to pharmacological agents.

[Clinical experience of anesthesia management in heart transplantation]. / Klinicheskii opyt anesteziologicheskogo obespecheniia transplantatsii serdtsa.

An experience is described of anesthesiological management of orthotopic heart transplantations performed to 22 males aged 16 to 54 years and 5 females aged 27 to 43 years with dilation cardiomyopathy (20 cases), ischemic heart disease (5 cases), Abramov-Fiedler myocarditis (1 case) and the combination of the aortic valve defect with ischemic heart disease (1 case). Techniques of anesthesiological management in recipients and donors are described. The period necessary for the recovery of the donor heart function is characterized and cardiotropic transplant support is described. Specific clinical course of the anesthesia depending on the pulmonary artery pressure, the type of general anesthesia used in recipients and the use of catecholamines for hemodynamic maintenance in donors during heart excision have been analysed.