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Pretransplant Considerations

  • Angela Lorts
  • Lara Danziger-Isakov
  • Kathleen Campbell
Reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)

Abstract

The outcomes from pediatric liver transplantation have improved dramatically since its introduction as a lifesaving procedure in the 1980s; however, it remains a complex and demanding surgery, and while it cures chronic liver disease, it creates a variety of new risks associated with the procedure itself and the lifelong need for immunosuppression. Ensuring the best outcomes following liver transplantation requires that transplant professionals closely monitor patients, beginning long before transplant becomes necessary, in order to recognize indications for transplantation, facilitate timely transplant, and minimize the risk of perioperative complications. Particular attention to optimizing nutritional status, recognizing and mitigating cardiac complications associated with liver disease (high cardiac output failure associated with low systemic vascular resistance, diastolic abnormalities, hepatopulmonary syndrome, and portopulmonary hypertension), and aggressive planning to maximize vaccinations and prevent infectious complications is essential to long-term posttransplant health and well-being.

Keywords

Nutritional failure Cardiopulmonary complications Cirrhotic cardiomyopathy Immunizations Frailty Infectious risk 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Angela Lorts
    • 1
  • Lara Danziger-Isakov
    • 2
    • 4
  • Kathleen Campbell
    • 3
  1. 1.The Heart InstituteCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  2. 2.Division of Infectious Diseases/Department of PediatricsUniversity of CincinnatiCincinnatiUSA
  3. 3.Pediatric Gastroenterology, Hepatolgy and NutritionCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  4. 4.Immunocompromised Infectious DiseasesCincinnati Children’s Hospital Medical CenterCincinnatiUSA

Section editors and affiliations

  • Vicky Lee Ng
    • 1
  • John Bucuvalas
    • 2
  1. 1.Division of Gastroenterology, Hepatology and NutritionThe Hospital for Sick ChildrenTorontoCanada
  2. 2.Pediatric Liver Care CenterCincinnati Children's Hospital Medical CenterCincinnatiUSA

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