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Anesthesia for Transplant Surgery

General anesthesia is provided for children and teenagers receiving transplant organs, such as the heart, liver, kidney and small bowel.

Anesthesiologists focus on techniques to protect the organ, maintain its nutrients and oxygen, replace fluids and manage blood loss.

Before the Operation

You and your child will meet your anesthesiologist before surgery. You will be asked questions about your child's medical history, allergies, current medications, previous anesthetic experience and current health status. Your child's airway, heart and lungs will be examined carefully. Laboratory tests may include a blood count, kidney function tests, liver function tests, clotting studies and/or cardiac echo.

If extremely anxious, your child may be sedated with a medication usually given intravenously (IV). This helps relax the child, makes the separation process from the parents smoother, and often provides amnesia so your child does not remember the experience.

During the Operation

General anesthesia is normally induced with intravenous medications. The airway is secured with a breathing tube, and anesthesia is maintained with a combination of anesthetic gases, muscle relaxants and pain medications. Occasionally medications will be used to improve the blood pressure or the heart function, if your child has a history of heart problems.

Anesthesia professionals will monitor your child closely during surgery. Routine equipment will check on the heart's electrical activity, blood pressure, oxygen levels in the blood, body temperature and breathing (measuring inhaled oxygen and exhaled carbon dioxide concentrations). A special blood pressure monitor (an arterial line) may be used to continuously monitor blood pressure. An arterial line is like a regular IV, but placed in an artery rather than a vein. Similarly, a central line may be used to monitor central venous pressure. Transfusion of blood and blood products to replace surgical blood losses is common.

After the Operation

After the surgery, your child will be cared for in the Pediatric Intensive Care Unit (PICU). The breathing tube may be kept in place for a period of time after surgery to help your child breathe. Pain management is usually provided by a computerized pump, called Patient Controlled Analgesia (PCA) or, in younger children, Nurse / Parent Controlled Analgesia (NCA).