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Anaesthetic management of adult intestinal and multivisceral transplantation 

Anaesthetic management of adult intestinal and multivisceral transplantation
Anaesthetic management of adult intestinal and multivisceral transplantation

Kyota Fukazawa

, Ernesto A. Pretto

, and Seigo Nishida

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date: 22 October 2019

Outcome following intestinal and multivisceral transplantation has improved significantly since 1995. Multivisceral transplantation is now considered a therapeutic option in the treatment of patients with complications resulting from short bowel syndrome (SBS). During this time the increased numbers of cases has resulted in major refinements of surgical technique and perioperative management, with a better understanding of gut immunology leading to the development of new immunosuppression protocols. These advances have contributed to marked improvements in graft and patient survival. However, the perioperative management of recipients of intestinal and multivisceral transplants remains challenging. This is due primarily to problems associated with vascular access and hypercoagulability, complex surgical procedures, and high rates of postoperative comorbidities. This chapter reviews the current status of intestinal and multivisceral transplantation, including major historical developments, surgical techniques, immunosuppression protocols, and intraoperative and postoperative management.

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