Abstract
Liver transplant patients presenting to the ED with abdominal pain offer unique challenges in diagnosis and management. In addition to the usual abdominal pathologies considered, the emergency medicine provider must consider unusual causes of pain that stem from anatomical complications related to the transplant procedure itself, organ rejection, and the effects of immunosuppressive medications. The timing of presentation in relation to the date of transplant is critical as this heavily influences the differential diagnoses and guides empiric antimicrobial therapy. Finally, early communication with the patient’s transplant team or surgeon is crucial to guide appropriate workup and disposition decisions.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Turtay MG, Oguzturk H, Aydin C, Colak C, Isik B, Yilmaz S. A descriptive analysis of 188 liver transplant visits to an emergency department. Eur Rev Med Pharmacol Sci. 2012;16(Suppl 1):3–7.
Savitsky EA, Votey SR, Mebust DP, Schwartz E, Uner AB, McCain S. A descriptive analysis of 290 liver transplant patient visits to an emergency department. Acad Emerg Med. 2000;7:898–905.
Unterman S, Zimmerman M, Tyo C, Sterk E, Gehm L, Edison M, Benedetti E, Orsay EM. A descriptive analysis of 1251 solid organ transplant visits to the emergency department. West J Emerg Med. 2009;10:48–54.
Trzeciak S, Sharer R, Piper D, Chan T, Kessler C, Dellinger RP, et al. Infections and severe sepsis in solid-organ transplant patients admitted from a university-based ED. Am J Emerg Med. 2004;22:530–3.
O’Shea DT, Humar A. Life-threatening infection in transplant recipients. Crit Care Clin. 2013;29(4):953–73.
Savitsky EA, Uner AB, Votey SR. Evaluation of orthotopic liver transplant recipients presenting to the emergency department. Ann Emerg Med. 1998;31:507–17.
Long B, Koyfman A. The emergency medicine approach to transplant complications. Am J Emerg Med. 2016;34:2200–8.
Nijland ML, Kersten MJ, Pals ST, Bemelman FJ, Ten Berge IJ. Epstein-Barr virus–positive posttransplant lymphoproliferative disease after solid organ transplantation: pathogenesis, clinical manifestations, diagnosis, and management. Transplant Direct. 2015;2(1):e48. https://doi.org/10.1097/TXD.0000000000000557.
Moini M, Schilsky ML, Tichy EM. Review on immunosuppression in liver transplantation. World J Hepatol. 2015;7(10):1355–68.
Levitsky J, Cohen SM. The liver transplant recipient: what you need to know for long-term care. J Fam Pract. 2006;55:136–44.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Sandiford, P., Loflin, R. (2019). What Are the Unique Considerations of Liver Transplant Patients with Abdominal Pain?. In: Graham, A., Carlberg, D.J. (eds) Gastrointestinal Emergencies. Springer, Cham. https://doi.org/10.1007/978-3-319-98343-1_115
Download citation
DOI: https://doi.org/10.1007/978-3-319-98343-1_115
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-98342-4
Online ISBN: 978-3-319-98343-1
eBook Packages: MedicineMedicine (R0)