Postoperative Care Following Hepatic Transplantation

  • Barbara M. DeRiso

Abstract

The perioperative care of liver transplant recipients challenges even the most skilled intensivists, anesthesiologists and surgeons. Few other patient populations routinely manifest as many synergistic problems and conflicting needs. Because multisystem failure is a relatively frequent catastrophe in liver recipients, the intensivist caring for these patients must be knowledgeable in many subspecialties, and have day-and-night availability of experienced consultants. Particularly invaluable are consultants with expertise in infectious diseases, radiology and pathology [4,37].

Keywords

Catheter Dopamine Pneumonia Meningitis Fentanyl 

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References

  1. 1.
    Bennett WM, Norman DJ, (1986) Action and toxicity of cyclosporine. Ann Rev Med 37: 215–224PubMedCrossRefGoogle Scholar
  2. 2.
    Cuervas-Mons V, Millan I, Gaveler JS, Starzl TE, Van Thiel DH, (1986) Prognostic value of preoperatively obtained clinical and laboratory data in predicting survival following liver transplantation. Hepatology 6: 922–927PubMedCrossRefGoogle Scholar
  3. 3.
    DeGroen PC, Aksamit AJ, Rakela J, Forbes GS, Krom RA, (1987) Central nervous toxicity after liver transplantation. N Engl J Med 317: 861–866CrossRefGoogle Scholar
  4. 4.
    Demitris AJ, Sheahan DG, (1988) The role of the pathology department in a liver transplant program. Gastro Clin North Am 17: 93–103Google Scholar
  5. 5.
    Dindzans VJ, Schade RR, Van Thiel DH, (1988) Medical problems before and after transplantation. Gastro Clin North Am 17: 19–31Google Scholar
  6. 6.
    Esquivel CO, Jaffe R, Gordon RD, Iwatsuki I, Shaw BW, Starzl TE, (1985) Liver rejection and its differentiation from other causes of graft dysfunction. Semin Liver Dis 5: 369–374PubMedCrossRefGoogle Scholar
  7. 7.
    Esquivel CO, Fung JJ, Markus B et al. (1987) OKT3 in the reversal of acute hepatic allograft rejection. Transplant Proc 19: 2443–2446PubMedGoogle Scholar
  8. 8.
    Gonwa TA, Klintmalm GB, Husberg BS, Olson L, Nery J, Roden J, (1988) Liver transplantation in patients with preexisting acute and chronic renal failure. Transplant Proc 20 suppl 1: 561–563Google Scholar
  9. 9.
    Gonwa TA, Poplawski SC, Husberg BS, Nery JR, Klintmalm GB, (1988) Cyclosporine nephrotoxicity in orthotopic liver transplantation. Transplant Proc 20 suppl 3: 401–404Google Scholar
  10. 10.
    Gordon RD, Iwatsuki S, Esquivel CO et al. (1987) Ex-perience with primary liver transplantation across ABO blood groups. Transplant Proc 19: 4575–4579PubMedGoogle Scholar
  11. 11.
    Hageman JR, Hunt CE, (1986) Fat emulsions and lung function. Clin Chest Med 7: 69–77PubMedGoogle Scholar
  12. 12.
    Hehir AJ, Jenkins RL, Bistrian BR, Blackburn GL, (1985) Nutrition in patients undergoing orthotopic liver trans-plant. JPEN 9: 695–700CrossRefGoogle Scholar
  13. 13.
    Iwatsuki S, Starzl TE, Gordon RD et al. (1987) Late morbidity and mortality after liver transplantation. Transplant Proc 19: 2373–2377PubMedGoogle Scholar
  14. 14.
    Iwatsuki S, Starzl TE, Todo S et al. (1988) Experience in 1000 liver transplants under cyclosporine-steroid therapy survival report. Transplant Proc 20 suppl 1: 498–504Google Scholar
  15. 15.
    Kang YG, Gelman S, (1987) Liver transplantation. In:Gelman S (ed) Anesthesia and organ transplantation. WB Saunders and Co, Philadelphia, pp 139–183Google Scholar
  16. 16.
    Koneru B, Tzakis AG, Bowman J, Cassavilla A, Zajko AB, Starzl TE, (1988) Postoperative surgical complications. Gastro Clin North Am 17: 71–91Google Scholar
  17. 17.
    Kusne S, Dummer JS, Singh N et al. (1988) Infections after liver transplantation. Medicine 67: 132 - 143PubMedCrossRefGoogle Scholar
  18. 18.
    Lerut J, Gordon RD, Iwatsuki S et al. (1987) Biliary tract complications in human orthotopic liver transplantation. Transplantation 43: 47–51PubMedCrossRefGoogle Scholar
  19. 19.
    Lerut JP, Gordon RD, Iwatsuki S, Starzl TE, (1988) Human orthotopic liver transplantation:surgical aspects in 393 consecutive grafts. Transplant Proc 20 suppl 1: 603–606PubMedGoogle Scholar
  20. 20.
    Makowka L, Stieber AC, Sher L et al. (1988) Surgical technique of orthotopic liver transplantation. Gastro Clin North Am 17: 33–51Google Scholar
  21. 21.
    Olutola PS, Hutton L, Wall WJ, (1985) Pleural effusion following liver transplantation. Radiology 157: 594PubMedGoogle Scholar
  22. 22.
    Perkins JD, Sterioff S, Wiesner RH et al. (1987) Conversion from standard cyclosporine to low-dose cyclosporine and azathioprine therapy as treatment for cyclosporine-related complications in liver transplant patients. Transplant Proc 19: 2434–2436PubMedGoogle Scholar
  23. 23.
    Poison RJ, Park GR, Lindop MJ, Farman JV, Calne RY, Williams R, (1987) The prevention of renal impairment in patients undergoing orthotopic liver grafting by infusion of low dose dopamine. Anaesthesia 42: 15–19CrossRefGoogle Scholar
  24. 24.
    Powell-Jackson PR, Carmichael FJ, Calne RY, Williams R, (1984) Adult respiratory distress syndrome and convulsions associated with administration of cyclosporine. Transplantation 38: 341–343PubMedCrossRefGoogle Scholar
  25. 25.
    Rimola A, Gaveler JS, Schade RR, El-Lankany S, Starzl TE, Van Thiel DH, (1987) Effects of renal impairment on liver transplantation. Gastroenterology 93: 148–156PubMedGoogle Scholar
  26. 26.
    Ringe B, Pichlmayr R, Lübbe N, Bornscheuer A, Kuse E, (1988) Total hepatectomy as temporary approach to acute hepatic or primary graft failure. Transplant Proc 20 suppl 1: 552–557PubMedGoogle Scholar
  27. 27.
    Shaw BW, Gordon RD, Iwatsuki S, Starzl TE, (1985) Retransplantation of the liver. Semin Liver Dis 5: 394–401PubMedCrossRefGoogle Scholar
  28. 28.
    Starzl TE, (1987) FK-506: a potential breakthrough in immunosuppression. Transplant Proc 19: 103Google Scholar
  29. 29.
    Starzl TE, (1987) New approaches in the use of cyclosporine. Transplant Proc 20 suppl 3: 356–360Google Scholar
  30. 30.
    Thompson CB, June CH, Sullivan KM, Thomas ED, (1984) Association between cyclosporine neurotoxicity and hypomagnesaemia. Lancet 1116–1120Google Scholar
  31. 31.
    Tisone G, Gunson BK, Buckels JA, McMaster P, (1988) Raised hematocrit — a contributing factor to hepatic artery thrombosis following liver transplantation. Transplantation 46: 162–163PubMedCrossRefGoogle Scholar
  32. 32.
    Tzakis AG, (1985) The dearterialized liver graft. Semin Liver Dis 5: 375–376PubMedCrossRefGoogle Scholar
  33. 33.
    Venkataramanan R, Burckhart GJ, Ptachcinski RJ, (1985) Pharmacokinetics and monitoring of cyclosporine following liver transplantation. Semin Liver Dis 5: 357–367PubMedCrossRefGoogle Scholar
  34. 34.
    Wheatley HC, Datzman M, Williams JW, Miles DE, Hatch FE, (1987) Long-term effects of cyclosporine on renal function in liver transplant recipients. Transplantation 43: 641–647PubMedCrossRefGoogle Scholar
  35. 35.
    Wood RP, Shaw BW, Starzl TE, (1985) Extrahepatic com-plications of liver transplantation. Semin Liver Dis 5: 377–384PubMedCrossRefGoogle Scholar
  36. 36.
    Yandza T, Rahier J et al. (1987) Orthoclone OKT3 in liver transplantation: experience in 21 patients. Transplant Proc 19: 3987–3990PubMedGoogle Scholar
  37. 37.
    Zajko AB, Cambell WL, Bron KM, Schade RR, Koneru B, Van Thiel DH, (1988) Diagnostic and interventional radiology in liver transplantation. Gastro Clin North Am 17: 105–143Google Scholar

Copyright information

© Springer-Verlag London Limited 1992

Authors and Affiliations

  • Barbara M. DeRiso

There are no affiliations available

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