Anesthesia for Pediatric Orthotopic Liver Transplantation

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Abstract
The anesthetic management of 68 liver transplantations in 50 pediatric patients is described. The surgical technique is briefly reviewed. The selection of an anesthetic technique was not as important as management of numerous intraoperative problems. Citrate intoxication secondary to massive blood transfusion in the hypothermic anhepatic patient is a major problem, as are coagulation deficiencies. Hyperkalemic cardiac arrest, also a significant hazard, produced the only intraoperative death.