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Anesthesia and Perioperative Care for Organ Transplantation

Schumann, Roman MD

doi: 10.1213/ANE.0000000000002483
Books, Multimedia, and Meeting Reviews
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Published ahead of print September 19, 2017.

Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, rschumann@tuftsmedicalcenter.org

Published ahead of print September 19, 2017.

Conflicts of Interest: Royalties for 2 obesity-related chapters in Up-To-Date.

This first edition of Anesthesia and Perioperative Care for Organ Transplantation was published by Springer Nature in 2017. The format is that of a traditional, up-to-date reference textbook for clinicians, and the layout is 8 × 11. Though the publisher also offers an eBook, the format is EPUB, PDF and there are not many additional digital features such as cross-linking with pertinent websites, utility for the preparation of educational materials, or the opportunity for ongoing updates of information for the reader. Such characteristics of contemporary educational and reference media may be increasingly expected by readers and could be considered by the publisher for future editions.

The 2 editors of this textbook are transplant anesthesiologists at the University of Pittsburgh who recruited 82 international contributors, although the majority are from the United States and almost half of the authors are based in Pittsburgh. Notably, the first foreword in this textbook was provided by the late Thomas E. Starzl, MD, PhD, an unforgettable pioneer in the world of liver and solid organ transplantation, shortly before his death in early 2017.

The text consists of 47 chapters that are organized into 9 parts. Each chapter contains subheadings that are not specified in the table of contents. The content covered in parts 1–9 includes general topics, lung, heart, special considerations for thoracic transplantation, kidney, pancreas, liver, multivisceral, and composite tissue graft transplantation. Each organ-specific part addresses preoperative, anesthetic, surgical, and postoperative critical care considerations, augmented by historical perspectives and future directions in some chapters. The detailed index beginning on page 571 contains an extensive list of key words, making the location of relevant areas of interest easy.

Part I, which is on general topics, contains an in-depth ethics review including organ allocation (US perspective), organ-specific considerations for infection prevention, and well-researched considerations for organ donation and donor management, including in the critical care setting. In parts II and III, lung and heart transplantation are addressed in all their nuances, including perioperative complications and critical care. Part IV, which explores special considerations for thoracic transplantation, provides detailed approaches for pulmonary hypertension, extracorporeal life support after transplantation, perfusion, and organ preservation management. Kidney transplantation, one of the most common solid organ transplantations in the United States, is described in detail along with considerations for pancreas transplantation in part V. While it includes a very useful approach to cardiac evaluation, it should also address specific recommendations for the intraoperative crystalloid choice and possibly a graphic algorithm or table that summarizes the anesthetic management. The latter is true also for some of the other chapters in this book. Intraoperative invasive arterial blood pressure monitoring for kidney transplantation is advocated as a standard, which some practitioners may not always agree with. Parts VI and VII describe the care for liver transplantation, including in the context of multiorgan transplantation. It is by far the most extensively discussed topic, taking up twice the number of pages as the other individual parts. It contains comprehensive, evidence-based approaches to virtually all aspects of care in the context of liver transplantation, including simulation training. Part VIII explores multivisceral transplantation and provides an excellent overview of this complex topic without being overbearing. The subheadings on surgical technique and vascular access are both useful and well described. The book concludes with part IX, which covers the relatively new field of composite tissue graft transplantation. A historical overview is combined with the worldwide experience to date with different types of composite tissue transplantation. Ethics, policy (United States), and reimbursement (United States) questions are briefly addressed.

Detailed regulatory and administrative information on solid organ transplantation or comparative international donor allocation practices and special considerations for pediatric organ transplantation are mostly beyond the scope of this book. The textbook does not explore donor and recipient research, QA/QI practices, recommendations for organ transplantation startup programs, or the utility of emerging noninvasive hemodynamic monitoring technologies for selected transplant recipients.

This textbook easily meets the criteria to be an authoritative, clinically relevant, comprehensive, and practical reference for transplant clinicians, including anesthesiologists, intensivists, nurses, physician assistants, and trainees. The content is well researched, organized, well written, and is largely evidence based. This resource presents a formidable alternative to similar available reference works in adult solid organ transplantation and may be considered a valuable addition to a departmental or personal educational collection. With its exhaustive coverage of adult liver transplantation, it begs to be added to the library of liver transplant anesthesia directors and their teams.

Roman Schumann, MDDepartment of Anesthesiology and Perioperative MedicineTufts Medical CenterTufts University School of MedicineBoston, Massachusettsrschumann@tuftsmedicalcenter.org

Copyright © 2017 International Anesthesia Research Society