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Liver Transplant


Well, I did my first liver transplant on call last night. I have NEVER given so many blood products, or had a pt. with so many lines....even in CVRU with IABP/open chest patients. It truly was fascinating though, they are such coagulopaths! We do TEGS on our livers, how about the rest of you? Do you find these helpful? Is anyone standardly using aprotinin gtts? One more thing, what do you think the max time should be for staying on veno-venous bypass? These cases are so intense and interesting, maybe this will get another "clinical" discussion going! :)

Yes!! I have a great interest in transplant anesthesia.

NCgirl - that is awesome -

i haven't had the opportunity to do a transplant and probably won't get the opportunity while in school -

what relaxant did you use?

Pavulon....it's not really a big issue in liver's, b/c they stay ventilated and sedated in SICU for a while postop. So, you're not having to worry if it "hangs around", b/c you won't be waking up. I'm curious if there are other facilities using something besides this- I'd hate to be redosing Roc or Vec for a LONG liver transplant.

What an awesome opportunity. I work in a MICU and we frequently care for very, very sick patients pre liver transplant. They are far and away our most challenging patients-- unfortunately, most of them die before a liver becomes available. It's always so exciting though when someone does get a liver and does well afterwards.

i wasn't sure if you had to be careful with metabolism and elimination issues in regard to transplants.. thanks!

Just wanted to respond because my mother had a liver transplant 5 years ago that saved her life (I'm not the RN - that's hubby whose shoulder I tend to read over). The operation was done in England where there was never any concern about her getting a liver, the docs told us right from the beginning not to worry about that as one always came in. And they were right, it did. It's sad that that is not the case in the USA - more people should step up to the plate and donate. All of my friends joined the organ donor list after she had her transplant because they were so moved by the experience.

Anyway, a little off topic but you just touched a subject after my heart. :coollook:

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