Living liver donor surgery: Report of initial anesthesia experience

The charts and anesthetic records of 12 patients who donated the left later al segment of their liver to a related infant or child to treat liver failu re were retrospectively reviewed. Blood loss, need for transfusion, fluids administered, surgical length, and perioperative complications were investi gated The records also were examined to determine the hemodynamic stability of patients undergoing donor hepatectomy to assess their need for invasive monitoring. There were no episodes of hypotension or hemodynamic instabili ty. The average operating time was 9.6 +/- 1.1 hours. The blood loss was 56 2 +/- 244 mt (range 300 to 1100 mt). Four patients received their own cell saver blood (200 mt. 220 mt, 300 mt, 475 mt), and one patient received 1 U (350 mL) of predonated autologous blood. The average hemoglobin decreased s ignificantly (p = 0.001) from a preoperative value of 14.1 +/- 1.2 to 12.3 +/- 1.8 g/dL in the recovery: room. All patients were extubated in the oper ating room or recovery mom. Patients were discharged home in 6.9 +/- 1.3 da ys (range 5 to 9 days). Living-related liver resection can be performed wit h noninvasive monitoring and without the need for heterologous blood produc ts. (C) 2000 by Elsevier Science Inc.