Liver transplant anesthesia - operating room tour

Anesthesia for liver transplant requires extensive preparation and advanced equipment, including central lines, multiple vasopressors, and transesophageal echocardiography. In this video, I show you the components of the liver transplant anesthesiologist's operating room setup.

0:00 Start
0:39 IV pole #1
1:09 Anesthesia machine
2:15 Defibrillator
2:32 Drugs
3:21 Echocardiography
3:45 IV pole #2
3:57 OR table
4:15 Rest of the OR

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Find Max Feinstein, MD online:
Instagram: @MaxMFeinstein
Twitter: @MaxMFeinstein
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The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.
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#Anesthesiology #Residency #MedicalSchool

[msbaird]

Fascinating stuff. I underwent a liver transplant in October of 2019. The anesthesiologist is the last person I remember speaking to before I woke up two days later. He must have done a good job because I did wake up and I'm doing fine.

[failsafe]

I had a liver transplant at Mount Sinai Hospital in NY on March 16, 2016. There's a chance I had it done in the OR featured in this video. As I was being rolled into the OR I was very scared. I didn't know if I was going to die or not. The last thing I remember I told the anesthesiologist that I was very worried. He said to me in the kindest way possible, "Alan we're going to take good care of you. "
Those words meant everything to me and they put me at ease. The next thing I know I woke up in the recovery room and I am ok 7 years later. Thank you to that anesthesiologist, the transplant surgeon Dr. Arvelakis and all those kind professionals that helped me at My Sinai.

[larryjohns]

All this reminds me of the DEDICATION it takes to be a Doctor as well as specializing in any field. Smart, hard working people all of you !

[breaflood]

I just donated the right side of my liver to my bestfriends future daughter-in-law this past April 17, 2023. This whole experience has been so Amazing and life changing for me and the recipient. My Anesthesia team and the Transplant surgeon team were so thorough and kind. Definitely a once-in-a-lifetime opportunity to help save someone's life... And, thank you so much, Dr. Feinstein, for all of your videos-I watched a lot of them pre-surgery to mentally prepare myself. Thank you for all of your knowledge and skill.

[knitpug]

Just had a liver transplant on March 31, still in hospital, feeling great. Have been following you for a while. Thank you for helping me be prepared!

[patrick]

After recently having a liver transplant, I'm thankful at least one of those machines, specifically the defibrillator weren't required. Although my surgery went well and I'm doing fantastic considering what I've gone through, it was really nice getting an overview of the room from this view with everything being explained. Thanks Dr. Feinstein for this video. Shoutout to Dr. Selvaggi, Dr. Shah, and Dr. Venkatasamy for my transplant surgery at Jackson Memorial Hospital in Miami.

[Rsthelen]

As a person that is headed down that road, that is extremely informative, thank you for that video.

[kenrogers]

Dr Feinstein, thank you for the tour. I underwent a liver transplant in March 2017, following an Alpha One diagnosis in 2012. My anesthesia team was awesome and I am forever grateful for how they talked me through the setup all the while reassuring me they had my back. While I don't remember their names, I do remember the face of the one as he placed the oxygen mask on me. My next memory was 3 days later. 

I am fully recovered now but I have required some subsequent incisional hernia repair surgeries and your videos have help me understand and appreciate your specialty. Thank you and all the best to you as you continue your career path.

[Kristen_michelle]

I’m a liver transplant recipient, 2018, so glad i found this video, gives me more insight into what happened that day. I had acute liver failure my liver died in 12 hours. I was listed right away with a meld score on 48, was put into a medically induced coma on sept 3, 2018 had my transplant sept 8th 2018 everything happened so fast i woke up and didn’t know what happened i just woke up with a new liver, talk about scary.

[petergriffin]

Yo i just realize you subtitle all your videos. That’s not easy. Mad respect to you for doing that doctor

[jamesamoh]

Wonderfully done and I know Anesthesiologists are paid well but watching this, I think it’s fair to demand even more. Haha

[Thwarptide]

Watching these videos presented by Dr Feinstein has given me an extremely heightened appreciation for Anesthesiologist. Its very rare to meet and greet an anesthesiologist let alone get to know them in the manner we would our surgeons. The last time I had surgery 10 years ago was for a 5.5 hr cochlear implant. Anesthesiologist are frick’n busy busy just prior to being taken in, so if you meet the anesthesiologist for 3 minutes, you’re lucky. I knew then that its pretty much a thankless profession. You never see them afterwards. In fact you never get to meet the surgical teams too. So on that day as the wheeled me into the OR, completely bombed out of my mind (good stuff) barely able to speak coherently, I fought to speak clearly and loud enough “in advance thank you everyone for your help today “. The last thing I remember was a few “you’re welcome(s)”. So when you first meet you anesthesiologist, thank them, its the last chance you’ll get. 👍

[BuickDoc]

Thanks for the video! It brings back memories of the first automated anesthesia record I ever saw, at Baylor Hospital, Dallas, in about 1987. I forget the Anesthesiologist's name but he was an early pioneer in liver transplant anesthesia in Texas. In the first transplants done at Baylor he had been overwhelmed trying to keep up with the Anesthesia Record. Huge numbers of blood products were given because there was no cell saver and surgical techniques were still evolving.
This was before useful desktop computers so he had a terminal installed from the Hospital main-frame. He developed transducers from his monitors (A-line, SG, CVP, EKG, etc.) which, via the terminal, fed to an X-Y plotter, which drew out the record. He also hooked up a barcode reader. (BTW, he also had to write all the computer code!)
He developed barcodes, in cooperation with the barcode gurus, for all the usual drugs. Tapes with those barcodes were attached to the drug syringes. When he gave a med he waved the syringe over a barcode reader. This caused the name and time of administration to be printed on the Record. He did have to manually enter the amount of drug.
All the blood products had bar codes from the Blood Bank, so he could easily enter each bag via the barcode reader as well.
At the end of the case he had a paper record of the anesthetic, accurate as to times of administration of drugs and blood products.
I was impressed...

[eisgeistschiller]

I'm an IONM student and HOPE he sees this. Seriously my class was supposed to get to see our first live case back in July, but the patient got cold feet. I took my first "practice" CNIM exam today and A LOT of Max's information helped me. Eventually I will get into a place for my clinicals. Its nice to get a real run down of the OR and NOT be the one on the table. Love ya Max!

[jeffreyswisher]

Hey Max! Really good job. You accurately portray the level of complexity of this operation and the equipment that makes it possible. I am a liver transplant anesthesiologist at one of the few private practice programs in the country. If you ever make your way to San Francisco or are interested in pursuing a career here, give me a call. Keep up the good work!

[TamilaRedzanova]

Amazing and breathtaking! Thank you Dr. Feinstein for your great job at not only being a good doctor, but also being unique anesthesiology expert filming such a great, interesting videos.

[AnneLo-hj]

I’m still amazed that I went through all of this. I feel badly that I don’t remember everyone. I do know that around 1000 people took care of me. I felt loved and cared for. I love my surgeon and continue my care at Massachusetts General Hospital. They saved me from a massive GI bleed and 2 liver cancers. My transplant was in 2013. I see this OR but I think the one I was in was a little smaller. I can still see the outside of the room when I pass by Jackson building. I can still easily cry when I think of everyone, of course my donor, who all saved my life :)

[phiberoptik]

What a gas, getting this info in this manner through the lens of technology. Anyone not in the profession would be awed by all this marvel yet clueless about what and how it's all used. Good stuff as usual.

[pewpewpewkaboomz]

as an anaesthetic dr in australia, glad to see the exact same equipment are used at the other end of the earth 👍

[mikennastephenson]

I'm waiting on a double lung and liver transplant. Very cool and informative to see what this room looks! Going in not knowing what all the machines are for can be overwhelming.