Liver transplantation pre-surgical management

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

Liver trasnsplantation Microchapters

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Patient Information

Overview

Historical Perspective

Indications

Pre-surgical management

Choice of donor

Epidemiology and Demographics

Techniques

Complications

Acute rejection

Immune therapy

Post-surgical infection

Prognosis

Overview

Pre-surgical management for liver transplantation includes laboratory testings such as ABO-Rh blood typing, Liver biochemical and function tests (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, bilirubin, international normalized ratio, Complete blood count, Creatinine clearance,serum sodium, serum alpha-fetoprotein, and Calcium and vitamin D levels. Cardiological testings include electrocardiogram, cardiac stress testing, Echocardiography , Pulse oximetry and ABG.

Liver transplantation pre-surgical management

Laboratory testing 

Cardiopulmonary evaluation 

Cancer screening

Hepatic imaging and HCC staging 

  • Hepatic imaging should be obtained to assess the vasculature and for tumor staging.
  • This is typically done with multiphase contrast-enhanced CT scanning or contrast-enhanced MRI.
  • If cross-sectional imaging cannot be obtained, the hepatic vasculature can be assessed with transabdominal ultrasonography with Doppler imaging or contrast-enhanced ultrasonography.

Upper endoscopy 

Bone density testing 

References

  1. Krowka MJ, Mandell MS, Ramsay MA, Kawut SM, Fallon MB, Manzarbeitia C; et al. (2004). "Hepatopulmonary syndrome and portopulmonary hypertension: a report of the multicenter liver transplant database". Liver Transpl. 10 (2): 174–82. doi:10.1002/lt.20016. PMID 14762853.
  2. Plotkin JS, Scott VL, Pinna A, Dobsch BP, De Wolf AM, Kang Y (1996). "Morbidity and mortality in patients with coronary artery disease undergoing orthotopic liver transplantation". Liver Transpl Surg. 2 (6): 426–30. PMID 9346688.
  3. Lentine KL, Costa SP, Weir MR, Robb JF, Fleisher LA, Kasiske BL; et al. (2012). "Cardiac disease evaluation and management among kidney and liver transplantation candidates: a scientific statement from the American Heart Association and the American College of Cardiology Foundation". J Am Coll Cardiol. 60 (5): 434–80. doi:10.1016/j.jacc.2012.05.008. PMID 22763103.