Educational Review: Error traps in anesthesia for pediatric liver transplantation

Heather A. Ballard*, Elin Jones, Marcella M. Malavazzi Clemente, Daniela Damian, Pete G. Kovatsis

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Anesthetic and surgical techniques for the liver transplantation have progressed considerably over the past sixty years; however, this procedure is still fraught with substantial morbidity. To increase the safety culture associated with the liver transplantation, we detail nine error traps associated with anesthesia for pediatric liver transplantation. These potential pitfalls are divided into the operative phases: pre-operative preparation (Failure to have a dedicated anesthesia team for pediatric liver transplantation); pre-anhepatic (Failure to prepare for massive blood loss, Failure to monitor for coagulation abnormalities); anhepatic including reperfusion (Failure to prepare for clamping of the inferior vena cava, Failure to recognize metabolic changes, Failure to maintain homeostasis for reperfusion, Failure to prepare for Post-reperfusion syndrome); and post-anhepatic (Failure to optimize liver perfusion, Failure to maintain hemostatic balance). By offering practical advice on the preparation and treatment of these error traps, we aim to better prepare anesthesiologists to take care of pediatric patients undergoing the liver transplantation.

Original languageEnglish (US)
Pages (from-to)1285-1291
Number of pages7
JournalPaediatric anaesthesia
Issue number12
StatePublished - Dec 2022


  • Liver
  • anesthesia
  • cirrhosis
  • coagulopathy
  • end stage disease
  • liver
  • liver transplantation
  • pediatrics

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Pediatrics, Perinatology, and Child Health


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