Liver transplantation remains a life-saving option for appropriate candidates with end-stage liver disease (ESLD), with almost 9,000 performed in the U.S. in 2019 (Am J Transplant 2021;21 Suppl 2:208-315). Five-year graft survival exceeds 75%, slightly higher for living related donation. Unfortunately, the national challenge of an inadequate supply of donated livers hampers expanded transplantation with >12,000 candidates waiting at the end of 2019, not counting attrition of candidates who fall off the waitlist due to disease progression (Am J Transplant 2021;21 Suppl 2:208-315).

Experienced, qualified anesthesiologists are integral to a successful solid organ transplant program and play important roles in the perioperative spectrum, including preoperative optimization and postoperative intensive care of these complex patients. Non-transplant anesthesiologists may be called upon to provide care for patients on the transplant waitlist with severe liver disease or a patient with a functioning graft for an incidental procedure. On behalf...

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