General Anesthesia for a Child With a Living Donor Liver Transplant After Hepatoblastoma and Metastatic Lung Tumor Resection

Few reports exist in dentistry about the use of general anesthesia in children after liver transplant. In this paper, we report our experience utilizing general anesthesia for oral surgery in a 9-year-old girl who had undergone living donor liver transplantation. She was diagnosed with hepatoblastoma at 4 months of age and underwent a living donor liver transplant at 7 months of age. Due to a maxillary odontoma, impacted maxillary supernumerary teeth, and retained maxillary primary teeth, the patient was scheduled for general anesthesia. Preoperative blood tests revealed mild liver dysfunction, but no other abnormalities were noted. General anesthesia was administered with sevoflurane, rocuronium, fentanyl, and remifentanil, and no complications arose during the perioperative period. The patient was discharged without any significant issues the day after surgery. Precautions for the anesthetic management of children who have undergone living donor liver transplantation include assessing the patient for preoperative liver dysfunction and avoiding liver dysfunction caused by drugs used in conjunction with general anesthesia. Anesthetic agents and adjunctive medications should be carefully considered for use in patients with liver disease.