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However, orthotropic liver transplantation decreases the frequency of metabolic decompensations and improves life expectancy. We report a case of a 4-year-old boy undergoing orthotropic liver transplantation to treat propionic acidemia. This case highlights the use of intraoperative monitoring of metabolic markers like urine ketones, arterial ammonia, and lactate levels as these patients are at risk for hyperammonemia and metabolic acidosis. Also, the relevance in outcomes when performing early extubation in fast-tracking recovery.<\/jats:p>","DOI":"10.1177\/23247096211015025","type":"journal-article","created":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T09:21:21Z","timestamp":1620811281000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Anesthetic Management for Pediatric Liver Transplantation in a Patient With Propionic Acidemia: A Case Report"],"prefix":"10.1177","volume":"9","author":[{"given":"Luis I.","family":"Rodriguez","sequence":"first","affiliation":[{"name":"University of Miami, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica J.","family":"Tainsh","sequence":"additional","affiliation":[{"name":"University of Miami, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliane","family":"Varga","sequence":"additional","affiliation":[{"name":"University of Miami, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4597-440X","authenticated-orcid":false,"given":"Ana C.","family":"Mavarez","sequence":"additional","affiliation":[{"name":"Augusta University, Augusta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,5,12]]},"reference":[{"key":"bibr1-23247096211015025","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-018-0987-z"},{"key":"bibr2-23247096211015025","doi-asserted-by":"publisher","DOI":"10.1002\/lt.25344"},{"key":"bibr3-23247096211015025","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.174799"},{"key":"bibr4-23247096211015025","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3046.2003.00072.x"},{"key":"bibr5-23247096211015025","doi-asserted-by":"publisher","DOI":"10.1002\/lt.25304"},{"key":"bibr6-23247096211015025","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-014-0130-8"},{"key":"bibr7-23247096211015025","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgme.2011.08.034"},{"key":"bibr8-23247096211015025","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgme.2011.09.026"},{"key":"bibr9-23247096211015025","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000422"},{"key":"bibr10-23247096211015025","first-page":"283","volume-title":"Nutrition Management of Patients with Inherited Metabolic Disorders","author":"Yannicelli S","year":"2010"},{"key":"bibr11-23247096211015025","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2006.00569.x"},{"key":"bibr12-23247096211015025","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgme.2012.10.022"},{"key":"bibr13-23247096211015025","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13313"},{"key":"bibr14-23247096211015025","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24036"},{"key":"bibr15-23247096211015025","doi-asserted-by":"publisher","DOI":"10.1089\/hum.2008.158"}],"container-title":["Journal of Investigative Medicine High Impact Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23247096211015025","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23247096211015025","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23247096211015025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:01:11Z","timestamp":1777449671000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23247096211015025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":15,"alternative-id":["10.1177\/23247096211015025"],"URL":"https:\/\/doi.org\/10.1177\/23247096211015025","relation":{},"ISSN":["2324-7096","2324-7096"],"issn-type":[{"value":"2324-7096","type":"print"},{"value":"2324-7096","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]},"article-number":"23247096211015025"}}