Anesthetic management of patients undergoing living donor liver transplantation

Living donor liver transplantation (LDLT) is now routinely performed upon a lack of liver grafts from deceased donors. In addition to surgical technique, anesthetic management for LDLT is also important for both the safety of recipients and good surgical outcomes. Three phases, which are preanhepatic, anhepatic, and neohepatic phases, constitute the process of LDLT. Recipients, who already have physiological derangements caused by a nadir of hepatic function, encounter physiologically challenging conditions specific to each phase. Therefore, induction and maintenance of anesthesia and hemodynamic monitoring during the anesthesia should be tailored to patients’ underlying medical conditions and physiological challenges associated with surgical procedures performed during each phase. In this regard, this review will deal with anesthetic managementof recipients undergoing LDLT, particularly according to each phase.