BookVijay Vohra, Nikunj Gupta, Annu Sarin Jolly, Seema Bhalotra, editors.
Summary: The book covers all aspects of peri-operative anesthetic management of liver transplant patients. It provides a comprehensive coverage of the relevant history, surgeons, hepatologists, intensivists and pediatricians perspective of the disease, its pathogenesis, clinical presentation and indication for transplant. It discusses the practical aspects like fluid management and use of vasopressors. The book is divided into sections for a better and comprehensive delivery of information. Individual sections provide up to date information on the pre-operative issues and optimisation, intra-operative care and management and post-operative critical care issues and management of all transplant patients with special emphasis on recent advances. Separate sections cover ICU care of these patients in great detail and anesthetic management of pediatric liver transplant. The book includes anesthetic techniques involved in conducting multiorgan transplant. It discusses clinical approach to a patient with acute liver failure, brain death criteria and laws and organ donor management. It also presents newer techniques and methodologies adopted in the field of liver transplant. It includes ample illustrations, flowcharts, key points in each chapter, figures and photographs. The book contains chapters focusing on post-transplant patients presenting for non-transplant surgery. The book fills the gap in the literature for a comprehensive guide for the anesthetist performing or pursuing liver transplant, students/trainees/examinees who have a keen interest in this field and doctors dealing with such patients in critical care, donor management, pursuing general anesthesia. It is also helpful for hepatologists, intensivists and surgeons associated with liver transplant.
Contents:
Intro
Preface
Contents
About the Editors
1: The History of Liver Transplantation in India
1.1 Introduction
1.2 Background
1.3 Step I: Public Education
1.4 Step 2: Changing the Law
1.5 Step 3: The Initial Procedures
1.6 Step 4: Sustainable Programmes
1.6.1 Numbers
1.6.2 Statewise Distribution
1.6.3 The Situation in 2020
1.7 India Vs the World
1.8 Concerns
1.9 Recommendations
1.10 Conclusions
Part I: Basics Anatomy and Pathophysiology of Liver Disease
2: Physiological Role of Liver and Interpreting Liver Function Tests 2.1 Gross Anatomy of the Liver
2.1.1 Hepatic Blood Flow Regulation
2.2 Cellular Anatomy of the Liver
2.2.1 Models of Liver Microanatomy
2.3 Liver, the Immunological Gateway
2.3.1 Innate and Adaptive Immunity
2.3.2 Immune Tolerance
2.4 Hepatic Drug Metabolism
2.4.1 First Pass Effect
2.4.2 Phases of Drug Metabolism
2.4.3 Drug Extraction Ratio
2.5 Energy Metabolism
2.5.1 Glucose Homeostasis
2.5.2 Nitrogen Metabolism
2.5.3 Fatty Acid Metabolism
2.6 Role of the Liver in Coagulation
2.7 Hepatic Endocrine Function 2.8 Chronic Liver Disease
2.9 Interpreting Liver Function Tests
2.10 Tests Detecting Hepatocyte Injury
2.10.1 Serum Aminotransferases
2.10.2 AST to ALT Ratio
2.10.3 Lactate Dehydrogenase
2.11 Tests Detecting Injury to Bile Ducts
2.11.1 Alkaline Phosphatase
2.12 5′-Nucleotidase
2.13 Gamma-Glutamyl Transferase
2.14 Tests Assessing Biliary Organic Anion Transport
2.14.1 Serum Bilirubin
2.15 Tests Measure Hepatic Synthetic Capacity
2.15.1 Serum Proteins
2.16 Prothrombin Time and International Normalized Ratio 2.17 Tests Measuring Blood Flow and Metabolic Capacity of Liver
2.18 Pattern of Liver Test Abnormalities
2.19 Monitoring Liver Transplant
References
3: Surgical Anatomy of the Liver
3.1 Introduction
3.2 Ligaments of the Liver (Fig. 3.1)
3.2.1 Ligamentum Venosum (Arantius Ligament)
3.3 Lobar and Segmental Anatomy of the Liver
3.3.1 Functional Surgical Anatomy of the Liver
3.3.2 Bismuth's Liver Segmentation
3.4 Caudate Lobe
3.4.1 Hepatocaval Ligament (Makuuchi Ligament)
3.4.2 Riedel Lobe (Fig. 3.8)
3.5 Hepatic Veins (Venous Outflow) 3.5.1 Right Inferior Hepatic Veins: RIHV (Fig. 3.11)
3.5.2 Inferior Phrenic Veins
3.6 Anatomical Relations Around the Hilum
3.6.1 Extrahepatic and Intrahepatic Vasculature
3.7 Portal Vein
3.8 Hepatic Artery
3.9 Biliary Anatomy
3.9.1 Intrahepatic Bile Duct Anatomy
3.9.2 The Right Hepatic Duct
3.9.3 The Left Hepatic Duct
3.9.4 Extrahepatic Biliary Anatomy
3.9.5 Biliary Ductal Anomalies
3.9.6 Bile Duct Blood Supply
3.10 Gallbladder and Cystic Duct
3.10.1 The Calot's Triangle (Fig. 3.19)
References