Liver transplant patients

2013 ◽  
pp. 343-357
Author(s):  
Daniel Marks ◽  
Marcus Harbord
Keyword(s):  
Liver Transplant ◽  
Performance Status ◽  
Disease Recurrence ◽  
Secondary Malignancy ◽  
Transplant Patients ◽  
Medical Disorders ◽  
Surgical Complexity ◽  
Immunosuppressant Medications ◽  
Long Term Prognosis

Management of liver transplant patients with abnormal LFT Early surgical complications Rejection Chronic biliary complications Infections Medical disorders Secondary malignancy Immunosuppressant medications Disease recurrence and long-term prognosis The management of chronic liver disease has been transformed by orthotopic and live-related liver transplantation. Early post-surgical outcomes are closely linked to preoperative performance status, quality of the donor organ, and surgical complexity. Advances in operative techniques and immunosuppressive therapies have improved survival to 90% at 1y, 70% at 5y, and 50% at 10y. The prevalence of long-term complications has correspondingly increased, many of which arise secondary to prolonged use of immunosuppressants....

Medical Management after Liver Transplantation

2019 ◽  
Vol 03 (04) ◽  
pp. 305-313
Author(s):  
Shravan Dave ◽  
Veeral H. Ajmera
Keyword(s):  
Liver Disease ◽  
Liver Transplant ◽  
Medical Management ◽  
High Risk Population ◽  
Nonalcoholic Fatty Liver ◽  
Post Transplant ◽  
Transplant Patients ◽  
Complex Interactions ◽  
Organ Systems

AbstractMedical management of the liver transplant recipient requires consideration of the complex interactions between the transplanted liver, immunosuppression and all organ systems. An aging transplant population, improvement in long-term liver transplant outcomes, and the increase in nonalcoholic fatty liver disease as an indication for transplant have amplified the number of co-morbidities among post-transplant patients. In addition to balancing immunosuppression with infection risk, medical management of the transplanted patient includes monitoring for, and treating, recurrence of the primary liver disease, metabolic syndrome, cardiovascular disease, and post-transplant neurologic and renal dysfunction. Additionally, general healthcare maintenance such as management of osteoporosis, immunizations, and screening for malignancy are essential in this high-risk population. In this review, we summarize the evidence behind best practices for the current medical management of the post liver transplant patient.

scholarly journals Immunosuppression induction with rabbit anti-thymocyte globulin with or without rituximab in 1000 liver transplant patients with long-term follow-up

2012 ◽  
Vol 18 (7) ◽  
pp. 786-795 ◽  
Author(s):  
Richard S. Mangus ◽  
Jonathan A. Fridell ◽  
Rodrigo M. Vianna ◽  
Paul Y. Kwo ◽  
Jeanne Chen ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Transplant Patients ◽  
Long Term Follow Up

scholarly journals 3421 Evaluation of novel biomarkers of hepatocellular carcinoma development and recurrence in liver transplant patients

2019 ◽  
Vol 3 (s1) ◽  
pp. 143-144
Author(s):  
Jenna Mancinelli ◽  
David Walls ◽  
Baoli Chang ◽  
Brendan Keating ◽  
Maarouf Hoitet ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Clinical Utility ◽  
Genetic Variant ◽  
Prediction Models ◽  
Disease Recurrence ◽  
Visceral Adiposity ◽  
Transplant Patients ◽  
Increased Risk ◽  
Novel Biomarkers ◽  
Level Of Risk

OBJECTIVES/SPECIFIC AIMS: Given the poor prognosis of HCC and its increasing incidence worldwide, identifying biomarkers of HCC has been an active area of research. While biomarkers are being identified at a rapid pace, many are still in early phases of clinical study and very few have proven clinical utility. The objective of this study is to identify novel biomarkers of HCC and evaluate their clinical utility as predictors of disease development and prognosis with specific emphasis on disease recurrence after liver transplantation. Biomarkers will be identified through GWAS, as well as through analysis of qualitative and quantitative liver traits by magnetic resonance imaging (MRI). These novel biomarkers will then by implemented into risk prediction models aimed to assess an individual’s risk for development of HCC and stratify their level of risk according to predicted disease prognosis. METHODS/STUDY POPULATION: This will be a case-control study, analyzing data from previously created biorepositories from four cohorts of recipients across multiple centers which have undergone liver transplant. First, a GWAS will be performed to identify genetic variant(s). Second, pre-transplant MRI’s will be evaluated using CAVASS software to assess liver quantitative and qualitative traits, including visceral adiposity. Lastly, these findings will be implemented into risk stratification models to assess each individual’s level of risk for development of HCC and for recurrence of HCC after transplant. RESULTS/ANTICIPATED RESULTS: We hypothesize that genetic variant(s) are associated with positive HCV status and the development of HCC. Additionally, we hypothesize that increased visceral adiposity measured by MRI will have an association with recurrence of HCC after transplant. Lastly, we hypothesize that possession of these aforementioned features will be associated with an increased risk of HCC development and recurrence after transplant. DISCUSSION/SIGNIFICANCE OF IMPACT: As more is learned about the nature and reliability of these biomarkers, their potential clinical applications will be revealed. Ideally these proposed risk score models will ultimately be used by clinicians to provide personalized disease management while optimizing the allocation of health care resources. For instance, this may lead to changes in the MRI screening frequency of patients considered to be at high risk for HCC. The ability to diagnose patients early and provide personalized therapies may ultimately result in fewer disease related mortalities in the future.

scholarly journals Long-term Combination of Interferon Alfa-2b and Ribavirin for Hepatitis C Recurrence in Liver Transplant Patients

2001 ◽  
Vol 1 (4) ◽  
pp. 350-355 ◽  
Author(s):  
Arno Kornberg ◽  
Merten Hommann ◽  
Andrea Tannapfel ◽  
Thomas Wagner ◽  
Thomas Grube ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Liver Transplant ◽  
Interferon Alfa ◽  
Transplant Patients ◽  
Hepatitis C Recurrence

scholarly journals Care of the Liver Transplant Patient

2014 ◽  
Vol 28 (4) ◽  
pp. 213-219 ◽  
Author(s):  
Mamatha Bhat ◽  
Said A Al-Busafi ◽  
Marc Deschênes ◽  
Peter Ghali
Keyword(s):  
Liver Transplant ◽  
Transplant Patient ◽  
Keywords Liver Transplantation ◽  
Metabolic Complications ◽  
Transplant Patients ◽  
Medical Issues ◽  
Metabolic Bone ◽  
Increased Risk

OBJECTIVE: To provide an approach to the care of liver transplant (LT) patients, a growing patient population with unique needs.METHODS: A literature search of PubMed for guidelines and review articles using the keywords “liver transplantation”, “long term complications” and “medical management” was conducted, resulting in 77 articles.RESULTS: As a result of being on immunosuppression, LT recipients are at increased risk of infections and must be screened regularly for metabolic complications and malignancies.DISCUSSION: Although immunosuppression is key to maintaining allograft health after transplantation, it comes with its own set of medical issues to follow. Physicians following LT recipients must be aware of the greater risk for hypertension, diabetes, dyslipidemia, renal failure, metabolic bone disease and malignancies in these patients, all of whom require regular monitoring and screening. Vaccination, quality of life, sexual function and pregnancy must be specifically addressed in transplant patients.

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