Anesthesia for Transplant Surgery Jayashree Sood, Vijay Vohra
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Anesthesia for Transplant Surgery
Anesthesia for Transplant Surgery
Jayashree Sood MD FFARCS PGDHHM FICA Senior Consultant and Chairperson Department of Anesthesiology, Pain and Perioperative Medicine Sir Ganga Ram Hospital, New Delhi, India Vijay Vohra MD FRCA FICA Senior Consultant, Chairman Department of Liver Transplant, GI Anesthesia and Intensive Care Institute of Liver Transplantation Medanta The Medicity, Gurgaon, Haryana, India ForewordDS Rana
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Anesthesia for Transplant Surgery
First Edition: 2014
9789351521396
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Contributors
  • Amitabh Dutta md pgdhr (Human Rights)
  • Consultant
  • Department of Anesthesiology,
  • Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Anil Jain md
  • Senior Consultant and Vice Chairperson
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Anjali Gera md
  • Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Anjeleena Kumar Gupta da frca
  • Consultant
  • Department of Anesthesiology
  • Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Archna Koul md
  • Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Arun Maheshwari md
  • Senior Consultant and Chairperson
  • Department of Cardiac Anesthesia
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Bhuwan Chand Panday md
  • Associate Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Bimla Sharma md dgo mbahcs fica
  • Senior Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Chand Sahai da md
  • Senior Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Deepanjali Pant md
  • Senior Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Dinesh Gautam da dnb
  • Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Harsha Jauhari ms frcs fics fais
  • Senior Consultant and Chairperson
  • Department of Renal Transplant
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Jayashree Sood md ffarcs pgdhhm fica
  • Senior Consultant and Chairperson
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Manish Gupta md
  • Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Manish Kohli DA DNB
  • Associate Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Monish S Raut md fnb (Cardiac Anesth)
  • Clinical Assistant
  • Department of Cardiac Anesthesia
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Naimish Mehta ms facrsi febs
  • Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Naresh Dua md
  • Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Neetu Jain md dnb
  • Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Nitin Sethi dnb
  • Associate Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Prabhat Kumar Choudhary md
  • Associate Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Pradeep Jain md fica
  • Senior Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Pramoj Jindal dnb mnams
  • Consultant
  • Department of General Surgery
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Rachna Bhutani da dnb
  • Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Rahul Bhayana dnb
  • Consultant
  • Department of Anesthesiology and Critical Care
  • Kailash Hospital
  • Noida, Uttar Pradesh, India
  • Raminder Sehgal md fica
  • Senior Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Ranju Gandhi md
  • Assistant Professor
  • Department of Anesthesiology and Critical Care
  • Safdarjung Hospital and Vardhman Mahavir Medical College
  • New Delhi, India
  • Rashmi Jain dnb
  • Senior Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Savitar Malhotra md
  • Associate Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Shashank Pandey md dip (Cardiac Anesth)
  • Senior Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Shikha Sharma md
  • Senior Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Subhash Gupta md
  • Senior Consultant
  • Department of Anesthesiology, Pain and Perioperative Medicine
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Sudhir Chadha ms mch
  • Senior Consultant
  • Department of Renal Transplant and Urology
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Sumir Dubey ms mch
  • Consultant
  • Department of Cardiac Surgery
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Vibha Varma ms dnb
  • Consultant
  • Department of Surgical
  • Gastroenterology and Liver Transplant
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Vijay Vohra md frca fica
  • Senior Consultant and Chairman
  • Department of Liver Transplant
  • GI Anesthesia and Intensive Care
  • Institute of Liver Transplantation
  • Medanta The Medicity
  • Gurgaon, Haryana, India
  • Vinay Kumaran ms mch febs
  • Consultant
  • Department of Surgical Gastroenterology and Liver Transplant
  • Sir Ganga Ram Hospital
  • New Delhi, India
  • Vipin Tyagi ms dnb
  • Associate Consultant
  • Department of Renal Transplant and Urology
  • Sir Ganga Ram Hospital
  • New Delhi, India
Foreword
Since the first successful kidney transplantation between identical twins in the US almost six decades ago, the field of solid organ transplantation has made progress by leaps and bounds and despite setbacks along the way, the spirit of the transplant surgeons, the immunologists and others in transplantation has never flagged. However, these transplantations would not have seen the light of day without parallel development in anesthesiology and critical care; since the process of physically transplanting an organ in the recipient is one cog in the wheel.
The anesthesiologist posted with transplantation units in any hospital in any part of the world plays a key role in the good outcome of these patients who are in end stage organ failure. In our hospital we have a dedicated team of anesthesiologists who are involved in the perioperative care of this special group of patients.
Our hospital has been involved in transplantation surgery since 1985, first for kidney transplantation and then from 2001 for liver. We have in fact trained many anesthesiologists who are in practice elsewhere, thus widening the specialized services which have become available in India.
With the experience of many years and several cases (more than 2700 renal and 800 liver transplants, at the time of writing this book) the Department of Anesthesiology, Pain and Perioperative Medicine felt the time had come to put it all in a book so that others may share in the journey that they have undertaken so far, and influence a new generation of anesthesiologists with a special interest in anesthesia for organ transplantation.
I hope the reading of this book will increase your knowledge and spark your interest in this field of medicine.
DS Rana
Chairman-Board of Management
Sir Ganga Ram Hospital
New Delhi, India
Preface
Transplantation has been ‘referred to’ since ages in mythology. The results of transplant surgery in the initial years were not encouraging due to ‘rejection’ and ‘infection’. However with improved knowledge of immunosuppression and availability of newer and better immunosuppressive drugs, transplant of almost all organs is possible, with improved results.
In this book we have tried to cover all aspects related to ‘transplantation’. Beginning from history to physiology, immunosuppression, to surgical and anesthetic technique and finally postoperative pain relief. We have included transplantation pertaining to all organs. We have tried to give a very simple and practical approach to the management of this group of patients.
All the contributing authors are experts in their respective fields.
We do hope the readers will enjoy and benefit reading this book.
Jayashree Sood
Vijay Vohra
Acknowledgments
I am greatly indebted to Dr VP Kumra, Emeritus Consultant, Department of Anesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital, New Delhi, India who has always been a guiding force behind my academic achievements. I am grateful to Dr DS Rana, Chairman, Board of Management, Sir Ganga Ram Hospital, for writing a foreword and for his continuous support to our academic endeavors.
I would like to take this opportunity to acknowledge my colleagues who have contributed to this book. Their expertise has surely added to the scientific quality of the book.
My heartfelt thanks to Dr Vijay Vohra, my colleague and friend who has co-edited this book with me.
A special thanks to Ms Silvi Philips and Mr Prakash Bisht for their secretarial help. Their untiring efforts have made it possible to complete this book.
This book would not have been possible without the constant inspiration and support of my husband, Dr Subhash Sood and my blue eyed children Rahul, Ruchi and Dheeraj, and my grand daughters ‘Ayra’ and ‘Samaira’
Jayashree Sood
Acknowledgments
This is probably the first effort in India to publish a book on Anesthesia for organ transplantation. Internationally also there are not many who had ventured into this subject and therefore, there is no book with consolidated material on organ transplantation and anesthesia. Finally, this is a book which covers all aspects of organs transplantation and Dr Jayashree Sood must be complimented in the polarizing forces to get this book together. She has unending energy and huge respect in the anesthetic community.
All the authors should be complimented for their hard work. Ms Silvi Philips and Mr Prakash Bisht need a special mention for their secretarial help and for following up on all the contributors. It has been a pleasure to have been associated with all the contributors and hope the book will be well accepted by the readers.
Vijay Vohra