This manual, introduces advanced anaesthetic management ideas for the challenging patient with liver disease, and the peri-operative organ donor. Many Trusts are expanding their hepatobiliary services and all anaesthetists are more likely to encounter adult, parturient and paediatric patients in various stages of liver impairment for liver-related and non-liver interventions. UK anaesthesia trainees have also highlighted uncertainty in anaesthetic management during organ retrieval surgery. There is also a need to recognise the growing trend of living organ donation and how the donors and recipients may be affected. Both liver and retrieval anaesthesia present issues of optimisation and preservation of existing function and are addressed in this manual, originally written to accompany my two 1-day KLARA Courses at the Royal College of Anaesthetists in 2012, with help from specialists of the day, colleagues of the time, and many who went on to gainful employment within the sub-speciality.
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