Director of anesthesiology for liver transplantation: Existing practices and recommendations by the united network for organ sharing

Abstract

A new Organ Procurement and Transplantation Network/United Network for Organ Sharing bylaw recommends that all centers appoint a director of liver transplant anesthesia with a uniform set of criteria. We obtained survey data from the Liver Transplant Anesthesia Consortium so that we could compare existing criteria for a director in the United States with the current recommendations. The data set included responses from adult academic liver transplant programs before the new bylaw. The respondent rates were within statistical limits to exclude sampling bias. All centers had a director of liver transplant anesthesia. The criteria varied between institutions, and the data suggest that the availability of resources influenced the choice of criteria. The information suggests that the criteria used in the new bylaw reflect existing practices. The bylaw plays an important role in supporting emerging leadership roles in liver transplant anesthesia and brings greater uniformity to the directorship position.

Acute and chronic postsurgical pain after living liver donation: Incidence and predictors

“…Understanding and improving pain outcomes among living liver donors has been identified as a key priority by liver transplant clinicians and researchers and is a current focus of the National Institutes of Health–funded Adult‐to‐Adult Living Donor Liver Transplantation Cohort Study . The use of a prospective design in the present study allowed for unique insights into pain outcomes, and it suggests that there continues to be room for improvement in the management of pain after donor hepatectomy.…”

Service Requirements of Liver Transplant Anesthesia Teams: Society for the Advancement of Transplant Anesthesia Recommendations

“…There are limitations to our study that may reduce the effectiveness of the recommendations. The Delphi method relies on expert opinion, and we chose to use the OPTN/UNOS definition of the Director of Liver Transplant Anesthesia to define an expert in liver transplant anesthesia . Although this anesthesia training pathway differed from that of other certified and/or credentialed panelists, our approach still provided an objective and consistent measure of expertise for this study.…”

“…The Delphi method relies on expert opinion, (27) and we chose to use the OPTN/UNOS definition of the Director of Liver Transplant Anesthesia to define an expert in liver transplant anesthesia. (2) Although this anesthesia training pathway differed from that of other certified and/or credentialed panelists, our approach still provided an objective and consistent measure of expertise for this study. It is also possible that panelists introduced cultural bias into the Delphi process because of differences in institutional practices and professional attitudes.…”

“…Information about liver transplant anesthesia coverage is not required in the program coverage plan. The only OPTN/UNOS rules governing anesthesia care require that each center have a director of liver transplant anesthesia (DLTA) who meets specific training and case‐volume criteria . The policy was introduced in 2011 to ensure that every center has at least 1 anesthesiologist experienced in liver transplantation.…”

“…The only OPTN/UNOS rules governing anesthesia care Review ARticle | 583 require that each center have a director of liver transplant anesthesia (DLTA) who meets specific training and case-volume criteria. (2) The policy was introduced in 2011 to ensure that every center has at least 1 anesthesiologist experienced in liver transplantation. It does not comment on the service responsibilities of the liver transplant anesthesia team (LTAT).…”