Anesthesia and Perioperative Care in Reconstructive Transplantation

Raymond M Planinsic; Jay S Raval; Vijay S Gorantla

doi:10.1016/j.anclin.2017.04.008

Anesthesia and Perioperative Care in Reconstructive Transplantation

Anesthesiol Clin. 2017 Sep;35(3):523-538. doi: 10.1016/j.anclin.2017.04.008. Epub 2017 Jul 5.

Authors

Raymond M Planinsic¹, Jay S Raval², Vijay S Gorantla³

Affiliations

¹ Department of Anesthesiology, University of Pittsburgh Medical Center, 200 Lothrop Street, Suite C-200, Pittsburgh, PA 15213, USA. Electronic address: [email protected].
² Division of Transfusion Medicine, Department of Pathology and Laboratory Medicine, Transfusion Medicine Service, Hematopoietic Progenitor Cell Laboratory, University of North Carolina at Chapel Hill, 101 Manning Drive, Suite C3162, Chapel Hill, NC 27514, USA.
³ Departments of Surgery, Ophthalmology and Bioengineering, US Air Force, Wake Forest Institute for Regenerative Medicine, Wake Forest Baptist Medical Center, Richard H. Dean Biomedical Building, 391 Technology Way, Winston Salem, NC 27101, USA. Electronic address: [email protected].

PMID: 28784224
DOI: 10.1016/j.anclin.2017.04.008

Abstract

Reconstructive transplantation of vascularized composite allografts (VCAs), such as upper extremity, craniofacial, abdominal, lower extremity, or genitourinary transplants, has emerged as a cutting-edge specialty, with more than 50 programs in the United States and 30 programs across the world performing these procedures. Most VCAs involve complicated technical planning and preparation, protracted surgery, and complex immunosuppressive or immunomodulatory protocols, each associated with unique anesthesiology challenges. This article outlines key procedural, patient, and protocol-related aspects of VCA relevant to anesthesiology management with the goal of ensuring patient safety and optimizing surgical, immunologic, and functional outcomes.

Keywords: Anesthesia; Perioperative care; Reconstructive transplantation; Vascularized composite allografts.

Publication types

Review

MeSH terms

Anesthesia*
Humans
Perioperative Care / methods*
Plastic Surgery Procedures*
Transplantation, Homologous