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Postoperative Care of the Liver Transplant Patient

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Surgical Intensive Care Medicine

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Abstract

Historically, liver transplantation has been an operation of last resort for patients with irreversible chronic liver disease. The procedure has progressed from one that was experimental, entailed significant risk, and had discouraging long-term results to one with survival rates that exceed 90% at 1 year, 80% at 3 years, and 70% at 5 years (1). Liver transplantation is the therapy of choice for patients with end-stage chronic liver disease and those with fulminant hepatic failure (2). Refinement of the appropriate indications for liver transplantation, improvement of the surgical techniques, and better immunosuppression therapy has led to increased survival rates (3). Caring for patients who have undergone liver transplant in the surgical intensive care unit (SICU) is similar in many respects to management of other surgical patients. Proper fluid and electrolyte resuscitation along with careful management of nutritional support and immunosuppression help ensure favorable outcomes. This chapter reviews the evaluation and selection of transplantation recipients, their immediate postoperative care, and potential complications. Like other SICU patients, attention to detail and a rapid response to developing complications are critical for keeping morbidity and mortality as low as possible.

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Authors and Affiliations

  1. Lahey Clinic Medical Center, Burlington, MA, 01805, USA

    Elizabeth A. Pomfret M.D., Ph.D. & James J. Pomposelli M.D., Ph.D.

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  1. Elizabeth A. Pomfret M.D., Ph.D.
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  2. James J. Pomposelli M.D., Ph.D.
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Editors and Affiliations

  1. Surgical Intensive Care Unit, Department of Surgical Critical Care, Lahey Clinic Medical Center, Burlington, MA, USA

    John Merritt O’Donnell M.D. (Director, Chairman) (Director, Chairman)

  2. Department of Surgical Critical Care, Lahey Clinic Medical Center, Burlington, MA, USA

    Flávio Eduardo Nácul M.D. (Senior Fellow) (Senior Fellow)

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Pomfret, E.A., Pomposelli, J.J. (2001). Postoperative Care of the Liver Transplant Patient. In: O’Donnell, J.M., Nácul, F.E. (eds) Surgical Intensive Care Medicine. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-6645-5_50

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  • DOI: https://doi.org/10.1007/978-1-4757-6645-5_50

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-6647-9

  • Online ISBN: 978-1-4757-6645-5

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