• UCLA Health
  • myUCLAhealth
  • School of Medicine
UCLA Anesthesiology & Perioperative Medicine

UCLA Anesthesiology & Perioperative Medicine

UCLA Anesthesiology & Perioperative Medicine
  • About Us
    • Chair's Welcome
    • In the News
    • Our Expert Team
    • Our E-Magazine, Open Circuit
    • For Alumni
    • Academic Positions
    • Wellness Initiative
    • Community Outreach
    • Global Healthcare Initiatives
    • Contact Us
    • Maps & Directions
    • Giving
  • Our Specialties
    • Acute Pain and Regional Anesthesiology
    • Cardiothoracic Anesthesiology
    • Critical Care Anesthesiology
    • Liver Transplant Anesthesiology
    • Neurosurgical Anesthesiology
    • Nurse Anesthesia
    • Obstetric Anesthesiology
    • Ophthalmologic Anesthesiology
    • Pain Medicine
    • Pediatric Anesthesiology
    • Perioperative Medicine
    • Thoracic Anesthesiology
    • UCLA Comprehensive Pain Center
  • For Patients & Families
    • Preoperative Evaluation and Planning Center
    • Types of Anesthesia
    • Preparing for Surgery and Anesthesia
    • Preparing Your Child for Surgery and Anesthesia
    • Which Medications Should I Take?
    • When to Stop Eating and Drinking
    • Anesthesia for Labor and Delivery
    • Enhancing Your Recovery
    • Anesthesia and Child Development
    • We're Listening!
    • Contact Us
    • Maps & Directions
  • Education
    • Our Educational Programs
    • Residency Program
    • Fellowship Programs
    • Medical Students
    • MOCA Simulation Course
    • UCLA Simulation Center
    • ASA Annual Meeting
    • UCLA Annual Scientific Evening
    • Grand Rounds
    • Weekly Didactics & Journal Clubs
    • Visiting Professor Program
    • CME Programs
  • Research
  • For Referring Physicians
    • Risk Stratification
    • Requesting In-Person Preoperative Consultation at PEPC
    • Requesting Preoperative Telephone Screening
    • UCLA Requirements for the Preoperative History and Physical Examination
    • Criteria for Outpatient Venues
    • Guidelines for Preoperative Laboratory Testing
    • Guidelines for Preoperative Cardiac and Pulmonary Testing
    • NPO Guidelines
    • What Medications Should Patients Take Before Surgery?
    • Requesting a Pre-Surgical Pain Medicine Consultation
    • Referring a Patient For Chronic Pain Consultation and Management
  • Our Physicians
    • Faculty Physicians
    • Attending Physicians
  • UCLA Health
  • myUCLAhealth
  • School of Medicine

UCLA Anesthesiology & Perioperative Medicine

Our Specialties

Our Specialties

Our Specialties

  • Acute Pain and Regional Anesthesiology
  • Cardiothoracic Anesthesiology
  • Critical Care Anesthesiology
  • Liver Transplant Anesthesiology
  • Neurosurgical Anesthesiology
  • Nurse Anesthesia
  • Obstetric Anesthesiology
  • Ophthalmologic Anesthesiology
  • Pain Medicine
  • Pediatric Anesthesiology
  • Perioperative Medicine
  • Thoracic Anesthesiology
  • UCLA Comprehensive Pain Center
  • Acute Pain and Regional Anesthesiology
  • Cardiothoracic Anesthesiology
  • Critical Care Anesthesiology
  • Liver Transplant Anesthesiology
  • Neurosurgical Anesthesiology
  • Nurse Anesthesia
  • Obstetric Anesthesiology
  • Ophthalmologic Anesthesiology
  • Pain Medicine
  • Pediatric Anesthesiology
  • Perioperative Medicine
  • Thoracic Anesthesiology
  • UCLA Comprehensive Pain Center
  1. Home
  2. Our Specialties
  3. Liver Transplant Anesthesiology

Liver Transplant Anesthesiology

Share this
Liver Transplant Anesthesiology

The Division of Liver Transplant Anesthesiology at UCLA began in 1984, when the first liver transplant was performed at UCLA. At the time, UCLA was the only liver transplant program in the western U.S. Since 1984, UCLA has performed 6000 liver transplants, making UCLA the most active program in the world. The division provides specialized care for liver transplant and hepato-pancreato-biliary (HPB) cases at UCLA’s main quaternary-care teaching hospital, Ronald Reagan Medical Center.

In This Section:

  • Our Clinical Practice
  • Research in Liver Transplant Anesthesiology
  • Fellowship Training
  • Information for Patients and Families
  • Our Physicians

 

Our Clinical Practice

Our service provides care for solid organ abdominal transplantation including liver, small bowel, multi-visceral and combined liver-kidney recipients. Both adult and pediatric liver and bowel transplant patients are cared for by the service. HPB patients undergoing elective surgery are scheduled with the liver transplant anesthesiology service. Common procedures for HPB patients include resection of hepatocellular carcinoma and resection of hepatic metastases of colon cancer. Additional cases performed for end-stage liver disease patients include shunt procedures such as TIPS, liver biopsies, ERCP, and tunneled central venous access including ports to name a few.

The acuity of these patients is unparalleled. Arterial lines, pulmonary artery catheters and transesophageal echocardiography (TEE) are used in many patients. In room, point-of-care laboratory analysis is available for hemoglobin, electrolytes, glucose and blood gases; coagulation studies, including viscoelastic testing (thromboelastometry) is available in the nearby operating room laboratory.

Transfusion medicine, echocardiography and liver disease are core didactic topics. LT anesthesiology faculty are frequent presenters and authors on these topics, as well as transplantation. Close collaboration occurs between the blood bank, cardiothoracic anesthesia, critical care, cardiology and hepatology, in addition to transplant surgery.

back to top

Research in Liver Transplant Anesthesiology

We maintain a prospective database of every liver transplant case with a focus on blood products administered, coagulation abnormalities, echocardiography findings, and metabolic derangements. This database has elucidated associations that only a high-volume center can discern, and serves as the source of a number of published studies in journals that include Liver Transplantation (Pan 2014; 20: 823) and American Journal of Transplantation (Xia 2015; 15: 687).

Another area of focus for our service is the pre-transplant cardiac evaluation, which remains controversial. UCLA served as the coordinating site for an evaluation of coronary angiography as a screening tool for liver transplant candidates that was published in the American Journal of Transplantation (Wray 2013; 13: 184), and a definitive article on the role of myocardial perfusion imaging in liver transplant candidates in the American Journal of Cardiology (Bhutani 2013; 111: 1057).

Active collaborations with the UCLA Division of Cardiology are investigating the role of left atrial volume index in predicting post-transplantation outcomes. The physician anesthesiologists on our service are widely recognized as experts in the management of high MELD (model for end-stage liver disease) transplant recipients. The service encourages faculty to participate in research, and several faculty members have advanced degrees in clinical research. Basic perioperative TEE certification is also encouraged.

Faculty are active contributors to fundamental texts, providing chapters on transplantation and care of the liver disease patients for over a dozen books, including Miller’s Basics of Anesthesia 7th edition (2017), Miller’s Anesthesia 8th edition (2015), Clinical Anesthesia 8th edition (Barash, ed., 2017) and UpToDate Anesthesia online (2017). In addition, faculty contribute to multidisciplinary consensus-based guidelines (Journal of Hepatology 2016; 64: 717).

back to top

Fellowship Training

The primary goal of the one-year liver transplant anesthesia fellowship is to prepare participants for an academic career that focuses on the perioperative care of high-acuity abdominal transplant patients. Important secondary goals include training in basic perioperative TEE (leading to basic TEE certification) and research in the domains of transplantation, transfusion, and/or coagulation monitoring. See the Fellowships section of our website for a complete list of the fellowship goals and objectives.

back to top

Information for Patients and Families

Prospective patients and their families are referred to the “For Patients & Families” section of our website for more information about anesthesia and surgery. General information about the admission process, lodging, and other resources may be found on the “For Patients & Visitors” area of the main UCLA Health website. Patients who are listed for transplantation are evaluated and examined in person by the Liver Transplant Anesthesiology service.

Our Physicians

Directors:

  • Randolph Steadman, MD, MS
  • Christopher Wray, MD

Faculty:

  • Michelle Braunfeld, MD
  • Anahat Dhillon, MD
  • Andrew Disque, MD
  • Brent Ershoff, MD, MS, MSCR
  • Vadim Gudzenko, MD
  • Christine Myo Bui, MD
  • Christine Nguyen-Buckley, MD
  • Jennifer Nguyen-Lee, MD
  • Victor Xia, MD

back to top

 

Like Us on Facebook Follow Us on Twitter Subscribe to Our Videos on YouTube Follow us on Instagram Add Us to Your Google+ Circles Connect with Us on LinkedIn Follow us on Pinterest Follow us on Flickr Follow us on Sharecare
UCLA Health hospitals rank among nation's best in U.S. News survey
  • UCLA Health
  • School of Medicine
  • School of Nursing
  • UCLA Campus
  • Directory
  • Newsroom
  • Publications
  • Giving
  • Careers
  • Volunteer
  • Privacy Practices
  • Nondiscrimination
  • Emergency
  • Smoke-Free
  • Terms of Use
  • 1-800-UCLA-MD1
  • Maps & Directions
  • Contact Us
  • Report Broken Links
  • Sitemap
Like Us on Facebook Follow Us on Twitter Subscribe to Our Videos on YouTube Follow us on Instagram Add Us to Your Google+ Circles Connect with Us on LinkedIn Follow us on Pinterest Follow us on Flickr Follow us on Sharecare

Sign in to myUCLAhealth