Liver Transplantation Questions & Answers

Updated: Jan 11, 2019
  • Author: Cosme Manzarbeitia, MD, FACS; Chief Editor: Vinay Kumar Kapoor, MBBS, MS, FRCS, FAMS  more...
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Questions & Answers

Overview

What is liver transplantation?

What are the constraints to meeting the annual demand for liver transplantation?

How are donated organs procured and distributed for liver transplantation?

What is the evolution of transplantation for the treatment of liver disease?

What is the prevalence of liver diseases requiring transplantation?

What is the anatomy of the liver relevant to transplantation?

How does UNOS classify patients for liver transplantation?

Which diagnoses are potential indications for liver transplantation?

Which complications of end-stage liver disease (ESLD) are indications for liver transplantation?

Which clinical conditions are indications for liver transplantation?

What are the absolute contraindications to liver transplantation by most programs?

What are the relative contraindications to liver transplantation?

How can the presence of established anatomical portopulmonary hypertension be an absolute contraindication for liver transplantation?

What is the prognosis following liver transplantation?

Workup

What are the steps in evaluation of candidates for liver transplantation?

What are mandatory consultations and clearances for liver transplantation?

What is the allocation system for liver transplantation?

How is the MELD score calculated for adult liver transplantation candidates?

How is the PELD score calculated for pediatric liver transplantation candidates?

How does the candidate selection committee determine who should be listed for liver transplantation?

What is the role of lab tests in the evaluation of liver transplantation candidates?

What is the role of imaging studies in the evaluation of liver transplantation candidates?

Which procedures may be indicated in the evaluation of liver transplantation candidates?

How are histologic findings categorized in liver transplantation candidates?

What is the Child-Turcotte-Pugh (CTP) classification of liver disease severity?

Treatment

Which complications of end-stage liver disease (ESLD) must be treated prior to liver transplantation?

How is ascites treated prior to liver transplantation?

How is spontaneous bacterial peritonitis (SBP) treated prior to liver transplantation?

How is hepatorenal syndrome (HRS) treated prior to liver transplantation?

How is encephalopathy treated prior to liver transplantation?

How are esophageal varices treated prior to liver transplantation?

How is pruritus treated prior to liver transplantation?

What are the surgical components of liver transplantation?

What is included in preoperative care for liver transplantation?

What is included in anesthetic management for liver transplantation?

What is included in interoperative monitoring during liver transplantation?

What is the role of the Rapid Infusor System during liver transplantation?

Which medications are used during liver transplantation?

What are the first steps performed in the donor operation for liver transplantation?

What are the most frequent anatomic variations in donor livers and what is their effect on transplantation?

How does the liver donor operation proceed following identification of anatomic variations?

What is included in back-table allograft preparation for liver transplantation?

How is the full liver recipient procedure performed in liver transplantation?

What is the standard liver transplantation technique?

What is the piggyback liver transplantation technique?

What is the procedure for liver transplantation in recipients with preexisting portal vein thrombosis?

What is the procedure for liver transplantation in recipients with intraoperative hepatic artery dissection?

What is the procedure for liver transplantation in recipients with preexisting transjugular, intrahepatic, portosystemic shunt (TIPS)?

How are partial liver transplantation procedures performed?

How are living-donor liver transplantations performed?

How is split liver transplantation performed?

What is included in ICU postoperative care following liver transplantation?

What is included in postoperative liver transplantation care following transfer from the ICU?

What is included in long-term monitoring following liver transplantation?

What is the role of immunosuppression therapy following liver transplantation?

How is acute rejection of liver transplantation treated?

How is chronic rejection of liver transplantation treated?

How is the etiology of allograft dysfunction diagnosed following liver transplantation?

What are the possible complications of liver transplantation?

How is primary graft failure following liver transplantation treated?

How are biliary complications following liver transplantation treated?

How is hepatic arterial thrombosis following liver transplantation treated?

Which tests are performed in the workup of fever following liver transplantation?

How is cytomegalovirus (CMV) infection following liver transplantation treated?

How are candidal infections following liver transplantation treated?

How is aspergillosis following liver transplantation treated?

How is cryptococcosis following liver transplantation treated?

How are phycomycetes infections following liver transplantation treated?

How are Legionella and Pneumocystis infections following liver transplantation treated?

How are the long-term infectious complications following liver transplantation managed?

How is posttransplantation lymphoproliferative disorder following liver transplantation treated?

How is arterial hypertension following liver transplantation treated?

How is diabetes mellitus (DM) following liver transplantation treated?

How is renal failure following liver transplantation treated?

How are malignancies following liver transplantation treated?

How is recurrent liver disease following liver transplantation treated?

What causes recurrence of alcoholic liver disease following liver transplantation?

What causes recurrence of NASH following liver transplantation?

How prevalent is recurrence of thrombosis following liver transplantation for Budd-Chari syndrome?

Which factors increase the risk for acute-on-chronic liver failure following liver transplantation?

When is liver transplantation indicated in the treatment of metabolic abnormalities?

How prevalent is recurrence of autoimmune liver disease following liver transplantation?

Which factors increase the risk for recurrent primary sclerosing cholangitis (PSC) following liver transplantation?

What is the role of xenotransplantation in liver transplantation?

How have the criteria for liver transplantation to treat HCC been expanded?

What is the role of neoadjuvant therapy for HCC prior to liver transplantation?

What is the role of liver transplantation in patients with HIV infection?