Liver Transplantation and the Elderly Candidate: Perioperative Considerations

Anesthesiol Clin. 2023 Sep;41(3):595-611. doi: 10.1016/j.anclin.2023.02.009. Epub 2023 Mar 22.

Abstract

Pioneered by Thomas Starzl in the early 1970s, liver transplant (LT) is nowadays often considered a final intervention and standard of care to cure many forms of acute and chronic end-stage liver diseases. Started in recipients younger than 60 years old, LT indications are now much broader, and at least, one-fifth of the candidates are older than 65 years. Problems associated with ageing and frailty in LT recipients and their impact on the entire perioperative course are discussed according to a modern anesthesiological perspective and the anesthesiologist covering the role of the perioperative (transplant) physician.

Keywords: Cardiac assessment; Elderly candidate; Frailty; General anesthesia; Hemodynamic instability; Liver transplantation; Preoperative evaluation.

Publication types

  • Review

MeSH terms

  • Aged
  • Aging
  • Humans
  • Liver Transplantation*
  • Middle Aged
  • Risk Factors