Peri-transplant Determinants of Outcome in Liver Transplantation
Optimizing outcomes for children undergoing liver transplantation involves ongoing multidisciplinary assessment of medical morbidities unique to the underlying disease and specific patient population. In3reasing understanding of cardiopulmonary and renal factors as impacting posttransplant outcomes as well as high level of heterogeneity in patient diagnoses presenting for liver transplantation requires a dynamic approach in evaluation.
Technical expertise remains critical to early success of pediatric liver transplantation, and single center as well as network analysis (OPTN, SPLIT, others) has identified variation in outcomes as well as opportunities for improvement. Critical assessment and prophylaxis or intervention for infection and optimizing renal status in the early posttransplant period are critical as is timely management of surgical complications.
KeywordsLiver transplant Early outcomes Surgical technique Medical and surgical complications
- Cursio R, Gugenheim J (2012) Ischemia-reperfusion injury and ischemic-type biliary lesions following liver transplantation. J Transp Secur 2012:164329Google Scholar
- Emond JC, Whitington PF, Thistlewaite JR, Cherqui D, Alonso EA, Woodle IS, Vogelbach P, et al (1991) Ann Surg 1990; 212:14–22. Transplantation of two patients with one liver: analysis of a preliminary experience with “split-liver” grafting hepatology. 14(3): 572.Google Scholar
- Gondolesi G, Selvaggi G, Tzakis A, Rodríguez-Laiz G, González-Campaña A, Fauda M, Angelis M, Levi D, Nishida S, Iyer K, Sauter B, Podesta L, Tomoaki K (2009) Use of the abdominal rectus fascia as a Nonvascularized allograft for Abdominal Wall closure after liver, intestinal, and Multivisceral transplantation. Transplantation 87(12):1884–1888CrossRefPubMedGoogle Scholar
- Hong JC, Yersiz H, Farmer DG, Duffy JP, Ghobrial RM, Nonthasoot B et al (2009) Longterm outcomes for whole and segmental liver grafts in adult and pediatric liver transplant recipients: a 10-year comparative analysis of 2,988 cases. J Am Coll Surg 208(5):682–689. discusion 689–91CrossRefPubMedGoogle Scholar
- Kaul D, Green M (2014) Perioperative infections after organ transplantation. In: Kirk AD (ed) Textbook of organ transplantation, vol 2. Wiley-Blackwell, Chichester, pp 1105–1116Google Scholar
- Kelly DA, Bucuvalas JC, Alonso EM et al (2013) Long-term medical management of the pediatric patient after liver transplantation: 2013 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation. Liver Transpl 19(8):798–825CrossRefPubMedGoogle Scholar
- Lentine KL, Costa SP, Weir MR et al (2012) Cardiac disease evaluation and management among kidney and liver transplantation candidates: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. J Am Coll Cardiol 60(5):434–480CrossRefPubMedGoogle Scholar
- McDiarmid SV, Anand R, Group SR (2003) Studies of pediatric liver transplantation (SPLIT): a summary of the 2003 annual report. Clin Transpl 119–130.Google Scholar
- Meyers RL, Tiao GM, Dunn SP, Langham MR (2012) Liver transplantation in the management of unresectable hepatoblastoma in children. Front Biosci. (Elite Ed.) 4:1293–302Google Scholar
- Squires RH, Ng V, Romero R, Ekong U, Hardikar W, Emre S, Mazariegos GV (2014) Evaluation of the pediatric patient for liver transplantation: 2014 practice guideline by the American Association for the Study of Liver Diseases, American Society of Transplantation and the North American Society for Pediatric Gastroenterology. Hepatology 60(1):362–398CrossRefPubMedGoogle Scholar
- Troisi R, Cammu G, Militerno G, Baerdemaeker LD, Decruyenaere J, Hoste E, Smeets P, Colle I, van Vlierberghe H, Petrovic M, Voet D, Mortier E, Hesse UJ, de Hemptinne B (2003) Modulation of portal graft inflow: a necessity in adult living-donor liver transplantation? Ann Surg 237(3):429–436PubMedPubMedCentralGoogle Scholar