Postoperative Management of Liver Transplant Patients

2018 ◽  
Author(s):  
Aleah L. Brubaker ◽  
Marianne Chen ◽  
Amy Gallo
Keyword(s):  
Critical Care ◽  
Liver Transplant ◽  
Transplant Patient ◽  
Graft Function ◽  
Postoperative Management ◽  
Transplant Patients ◽  
Key Words Critical Care ◽  
Poor Graft Function ◽  
Primary Graft Nonfunction ◽  
Care Course

Management of the postoperative liver transplant patient can be extremely challenging. The combination of preoperative comorbidities and intraoperative complexity can make for a tenuous postoperative critical care course. Consideration and monitoring of graft function are paramount as poor graft function or primary graft nonfunction will affect every aspect of care. Our goal in this review is to use a systems-based approach to highlight the key tenets for postoperative management of liver transplant patients to help orchestrate integrated care across subspecialties.  This review contains 2 figures, 2 tables, and 94 references. Key words: critical care, liver transplant, systems-based management

Postoperative Management of Liver Transplant Patients

2017 ◽  
Author(s):  
Aleah L. Brubaker ◽  
Marianne Chen ◽  
Amy Gallo
Keyword(s):  
Critical Care ◽  
Liver Transplant ◽  
Transplant Patient ◽  
Graft Function ◽  
Postoperative Management ◽  
Transplant Patients ◽  
Key Words Critical Care ◽  
Poor Graft Function ◽  
Primary Graft Nonfunction ◽  
Care Course

Management of the postoperative liver transplant patient can be extremely challenging. The combination of preoperative comorbidities and intraoperative complexity can make for a tenuous postoperative critical care course. Consideration and monitoring of graft function are paramount as poor graft function or primary graft nonfunction will affect every aspect of care. Our goal in this review is to use a systems-based approach to highlight the key tenets for postoperative management of liver transplant patients to help orchestrate integrated care across subspecialties.  This review contains 2 figures, 2 tables, and 94 references. Key words: critical care, liver transplant, systems-based management

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.

scholarly journals Mending a Broken Heart: Treatment of Stress-Induced Heart Failure after Solid Organ Transplantation

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
N. Thao Galván ◽  
Kayla Kumm ◽  
Michael Kueht ◽  
Cindy P. Ha ◽  
Dor Yoeli ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Liver Transplant ◽  
Organ Transplantation ◽  
Transplant Patient ◽  
Solid Organ Transplantation ◽  
Kidney Transplant Patient ◽  
Solid Organ ◽  
Takotsubo Syndrome ◽  
Transplant Patients

Stress-induced heart failure, also known as Broken Heart Syndrome or Takotsubo Syndrome, is a phenomenon characterized as rare but well described in the literature, with increasing incidence. While more commonly associated with postmenopausal women with psychiatric disorders, this entity is found in the postoperative patient. The nonischemic cardiogenic shock manifests as biventricular failure with significant decreases in ejection fraction and cardiac function. In a review of over 3000 kidney and liver transplantations over the course of 17 years within two transplant centers, we describe a series of 7 patients with Takotsubo Syndrome after solid organ transplantation. Furthermore, we describe a novel approach of successfully treating the transient, though potentially fatal, cardiogenic shock with a percutaneous ventricular assistance device in two liver transplant patients, while treating one kidney transplant patient medically and the remaining four liver transplant patients with an intra-aortic balloon pump. We describe our experience with Takotsubo’s Syndrome and compare the three modalities of treatment and cardiac augmentation. Our series is novel in introducing the percutaneous ventricular assist device as a more minimally invasive intervention in treating nonischemic heart failure in the solid organ transplant patient, while serving as a comprehensive overview of treatment modalities for stress-induced heart failure.

scholarly journals Colonic Malakoplakia in a Liver Transplant Recipient

2007 ◽  
Vol 21 (11) ◽  
pp. 753-755 ◽  
Author(s):  
Peter TW Kim ◽  
Jennifer E Davis ◽  
Siegfried R Erb ◽  
Eric M Yoshida ◽  
Urs P Steinbrecher
Keyword(s):  
Transplant Recipient ◽  
Liver Transplant ◽  
Transplant Patient ◽  
Liver Transplant Recipient ◽  
Chronic Diarrhea ◽  
Immunosuppressive Drugs ◽  
Transplant Patients ◽  
History Of ◽  
Mucosal Edema ◽  
Antecedent Infection

Malakoplakia is a rare inflammatory condition seen in transplant patients. There are two previously reported cases of malakoplakia involving the gastrointestinal tract in liver transplant patients. The present paper reports a case of colonic malakoplakia in a 58-year-old woman, a liver transplant recipient who was receiving immunosuppressive drugs. She presented with chronic diarrhea while on tacrolimus. There was no history of antecedent infection. Colonoscopy showed patchy mucosal edema, but no discrete yellow plaques or nodules. The diagnosis was made by colon biopsies, which showed chronic inflammation with many histiocytes containing Michaelis-Gutmann bodies. Although rare, malakoplakia is one of many potential causes of diarrhea in a transplant patient. The present case indicates that malakoplakia may be associated with chronic diarrhea, even if there are no macroscopic lesions seen during colonoscopy.

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