{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T23:47:31Z","timestamp":1787701651905,"version":"build-2784847793"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Liver transplantation is the only curative treatment for end\u2010stage liver disease, yet perioperative management is complex and high\u2010risk. Variations in anesthetic practices may influence outcomes, but benchmarks are scant. This study characterizes liver transplant anesthesia practices in Canada, Australia, and New Zealand to identify patterns and opportunities to establish a \u201cstandard of care.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      An online questionnaire, adapted from the 2021 Society for the Advancement of Transplant Anesthesia survey, was distributed to the directors of liver transplant anesthesia at 18 adult and pediatric programs. The survey covered team structure, preoperative evaluation, intraoperative techniques, and postoperative management. Responses were stratified by annual transplant volume and analyzed using descriptive statistics and Fisher's exact test (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Dedicated transplant anesthesia teams existed in 76% of centers, with 31% offering transplant fellowships. Standardized preoperative cardiac evaluation was reported by 82%, though only 31% used formal risk\u2010stratification tools. More than half\u201459%\u2014used transesophageal echocardiography and pulmonary artery catheters intraoperatively. Renal replacement therapy was applied in 76%, and viscoelastic testing in 82% of centers. Graft flushing on the back\u2010table and in the surgical field occurred in 60% and 69% of programs, respectively; retrograde blood perfusion was used by 50%. Extubation at case\u2010end was rare, while up to 25% of patients were extubated within 2\u20134\u00a0h. Postoperative intensive care unit admission was nearly universal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings identified substantial practice variability, highlighting opportunities to develop consensus guidelines and targeted training to standardize perioperative care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70445","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T08:15:37Z","timestamp":1769501737000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Liver Transplant Anesthesia Practice Patterns in Canada, Australia, and New Zealand: Results From a Multi\u2010National Survey"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9009-3651","authenticated-orcid":false,"given":"Elizabeth","family":"van Rooy","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4373-0866","authenticated-orcid":false,"given":"Daniel","family":"Sellers","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6684-0497","authenticated-orcid":false,"given":"Stuart","family":"McCluskey","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6034-6941","authenticated-orcid":false,"given":"Cara","family":"Crouch","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Colorado  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2023.04.005"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20101253(22)00268\u20100"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14504"},{"key":"e_1_2_14_5_1","unstructured":"Government of Canada About Canada's Health Care System accessed November 6th 2025 https:\/\/www.canada.ca\/en\/health\u2010canada\/services\/canada\u2010health\u2010care\u2010system.html."},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050312118769211"},{"key":"e_1_2_14_7_1","unstructured":"Government of Canada Organ and Tissue Donation accessed November 6th 2025 https:\/\/www.canada.ca\/en\/health\u2010canada\/services\/healthy\u2010living\/blood\u2010organ\u2010tissue\u2010donation\/organ\u2010tissue\/pan\u2010canadian\u2010governance.html."},{"key":"e_1_2_14_8_1","unstructured":"Australian Government National Strategy for Organ Donation Retrieval and Transplantation accessed November 6th 2025 https:\/\/www.health.gov.au\/sites\/default\/files\/2024\u201010\/national\u2010strategy\u2010for\u2010organ\u2010donation\u2010retrieval\u2010and\u2010transplantation_0.pdf."},{"key":"e_1_2_14_9_1","unstructured":"The Transplantation Society of Australia and New Zealand Clinical Guidelines for Organ Transplantation from Deceased Donors accessed November 6th 2025 https:\/\/tsanz.com.au\/clinical\u2010guidelines\/liver."},{"key":"e_1_2_14_10_1","unstructured":"Canadian Blood Services Organs and Tissues accessed November 6th 2025 https:\/\/professionaleducation.blood.ca\/en\/organs\u2010and\u2010tissues\/leading\u2010practices\u2010and\u2010clinical\u2010guidelines."},{"key":"e_1_2_14_11_1","unstructured":"Trillium Gift of Life Network Ontario Organ Transplant Policies accessed November 6th 2025 https:\/\/www.giftoflife.on.ca\/resources\/pdf\/healthcare\/Ontario_Organ_Transplant_Policies_EN.pdf."},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.15017"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.13903"},{"key":"e_1_2_14_14_1","unstructured":"Australia and New Zealand Liver and Intestinal Transplant Registry 34th Annual Report accessed November 6th 2025 https:\/\/www.anzlitr.org\/wp\u2010content\/uploads\/2024\/04\/ANZLITR_34th_Annual.pdf."},{"key":"e_1_2_14_15_1","unstructured":"Canadian Blood Services Liver Listing & Allocation Forum Report and Recommendations May 26\u201027 2016 accessed November 6th 2025 https:\/\/profedu.blood.ca\/sites\/default\/files\/liver_listing_and_allocation_forum_report_\u2010_final_en.pdf."},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1089253217737043"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2024.03.013"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.1043674"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2011.01493.x"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000003452"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14642"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12103531"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70445","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.70445","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T11:09:52Z","timestamp":1776251392000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.70445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ctr.70445"],"URL":"https:\/\/doi.org\/10.1111\/ctr.70445","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-09-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70445"}}