Living Donor Liver Transplantation for an Infant Having Tracheostomy and Subglottic Stenosis: A Case Report

•Liver transplantation in pediatric patients with subglottic stenosis is uncommon.•Airway management should be based on the patient's condition and surgical procedure.•A multidisciplinary approach to securing stenotic airway can enable safe anesthesia. It is uncommon to perform liver transplant...

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Bibliographic Details
Published in:Transplantation proceedings 2024-04, Vol.56 (3), p.746-749
Main Authors: Lee, Ja Eun, Kim, Keoungah, Kwon, Ji-Hye, Kim, Gaab-Soo
Format: Article
Language:English
Subjects:
Humans
Infant
Intubation, Intratracheal
Laryngostenosis - etiology
Laryngostenosis - surgery
Liver Transplantation
Living Donors
Male
Tracheostomy
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Summary:•Liver transplantation in pediatric patients with subglottic stenosis is uncommon.•Airway management should be based on the patient's condition and surgical procedure.•A multidisciplinary approach to securing stenotic airway can enable safe anesthesia. It is uncommon to perform liver transplantation for patients with end-stage liver disease having tracheostomy. Usually, the tracheostomy cannula is changed to an oral endotracheal tube (ETT) before operation because ETT is easy to handle during operation. If routine oral ETT insertion is difficult, we should seek other solutions. We report a successful conversion from tracheostomy tube to ETT in a patient with subglottic stenosis. The patient was an 8-month-old infant who was scheduled for living donor liver transplantation due to acute hepatic failure. The original plan was to convert the tracheostomy tube to oral ETT, which failed due to aggravation of subglottic stenosis. An otolaryngologist performed balloon dilatation surgery, and ETT was successfully intubated. Owing to a multidisciplinary approach, the surgery was successfully performed without fatal adverse events, and the patient was later discharged with a tracheostomy. It is unusual for pediatric patients with tracheostomy tubes to undergo major surgeries like liver transplantation. We hope that this case of successful anesthetic management based on a multidisciplinary approach suggests new ideas to anesthesiologists seeking safe anesthesia.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2023.11.037