ABSTRACT
In the last 20 years, both pediatric and adult orthotopic liver transplantation (OLT) procedures have increased in the United States from approximately 2000 in 1988 to 6492 in 2007. Moreover, since 1999, nearly 5% of the transplanted livers each year have come from living donors (1). There are three distinct stages during OLT procedure: preanhepatic, anhepatic, and postanhepatic. Each stage is characterized by hemodynamic, metabolic, and hematological phenomena. Over the last decade, transesophageal echocardiography (TEE) has emerged as an invaluable tool to help the anesthesiologist adjust treatment for the complex hemodynamic fluctuations specific to OLT patients. After an overview of the surgical procedure, this chapter will present the role of perioperative TEE for OLT.
