BACKGROUND: The measurement of cardiac output is an essential part of anesthetic practice in patients undergoing liver transplantation. A thermodilution technique, using a pulmonary artery catheter is currently accepted as the gold standard in clinical practise. However, its use is associated with several limitations.

METHODS: An esophageal doppler monitor was compared with the thermodilution technique in 22 patients undergoing split graft transplantation from a living donor. Six measurement were taken during liver transplantation, 1) control, 2) dissection phase, 3) anhepatic phase, 4) reperfusion phase, 5) after hepatic artery anastomosis, and 6) end of surgery.

RESULTS: Significant difference were observed between the two measurement at all times studied with a strong correlation, except at the end of surgery (r > 0.4).

CONCLUSIONS: The use of esophageal doppler monitor results in cardiac output measurements which are considerably different from those obtained using thermodilution, but a strong correlation exists between two methods. Thus the use of esohageal monitoring can be recommended in patients undergoing liver transplantation for trend monitoring.