• C Paugam-Burtz, J Chatelon, A Follin, N Rossel, G Chanques, and S Jaber.
• Hôpital Beaujon, Clichy, France. catherine.paugam@bjn.aphp.fr
• Ann Fr Anesth Reanim. 2010 Jun 1; 29 (6): 419-24.

ObjectivesTo determine the evolution of French perioperative anaesthetic practices in liver transplantation between 2004 and 2008.Study DesignPhone survey.MethodsIn 2004 and 2008, a similar questionnaire has been administered by phone to a senior anaesthesiologist from each French centre performing adult liver transplantation (n = 21). Results were compared using Fisher test and p < 0.05 was considered significant.ResultsBetween 2004 and 2008, there was a trend towards an increase of centres performing transplantation for more than 40% of Child C patients (p = 0.1). Simultaneously, work force dedicated to liver transplantation cases has been reduced since in 2008, one anaesthesiologist was in charge in 90% of the centres (p = 0.06 vs 2004). Perioperative practices remained largely heterogeneous between centres with regard to hemodynamic monitoring, fluid and blood products management, antifibrinolytics use or postoperative analgesia.ConclusionsThis French survey has shown a reduction of work force dedicated to a liver transplantation from 2004 to 2008 simultaneously with a trend towards a greater severity of liver recipients. Practices heterogeneity reflect at least in part, unresolved questions about the best perioperative management for liver transplantation and the need for guidelines. Working for standardization of our practices and multicentric trials could allow gaining a better understanding of what should be the good practices in perioperative management of liver transplantation.

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