Liver transplantation overview: Difference between revisions
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==Liver transplantation indications== | ==Liver transplantation indications== | ||
Indications for liver transplantation include [[acute liver failure]], [[Cirrhosis|cirrhosis,]] [[Liver neoplasms]], and metabolic disorders such as [[Familial amyloid polyneuropathy]], [[Primary hyperoxaluria]], [[Cystic fibrosis]], [[Alpha 1-antitrypsin deficiency|alpha-1 antitrypsin deficiency]], [[glycogen storage disease]], t[[Tyrosinemia|yrosinemia]], h[[Hemochromatosis|emochromatosis]], [[Wilson's disease|Wilson disease]], and [[Acute intermittent porphyria]]. | Indications for liver transplantation include [[acute liver failure]], [[Cirrhosis|cirrhosis,]] [[Liver neoplasms]], and metabolic disorders such as [[Familial amyloid polyneuropathy]], [[Primary hyperoxaluria]], [[Cystic fibrosis]], [[Alpha 1-antitrypsin deficiency|alpha-1 antitrypsin deficiency]], [[glycogen storage disease]], t[[Tyrosinemia|yrosinemia]], h[[Hemochromatosis|emochromatosis]], [[Wilson's disease|Wilson disease]], and [[Acute intermittent porphyria]]. | ||
== Pre-surgical management == | |||
Pre-surgical management for liver transplantation includes laboratory testings such as [[ABO blood group system|ABO-Rh blood typing]], Liver biochemical and function tests ([[Alanine transaminase|alanine aminotransferase]], [[aspartate aminotransferase]], [[alkaline phosphatase]], [[bilirubin]], [[international normalized ratio]], [[complete blood count]], [[creatinine clearance]],[[Sodium|serum sodium]], [[Alpha fetoprotein|serum alpha-fetoprotein]], and [[calcium]] and [[vitamin D]] levels. Cardiological testings include [[electrocardiogram]], [[cardiac stress testing]], [[echocardiography]] , [[pulse oximetry]] and [[ABG]]. | |||
== Prognosis == | == Prognosis == | ||
Prognosis is good. One-year [[survival rates]] are 83%, 5-year survival is 76% and 10-year survival is 66%. Mortality rates in donors are 0.2% in the USA and vary from 0.1 to 1.0% worldwide. The risk associated with left-lobe donation may be lower than that with right-lobe donation. Recurrence varies according to the cause; [[hepatitis B virus]] is the commonest cause of recurrence followed by [[hepatitis C]] virus. Recurrence of [[Hepatitis B virus|HBV]] after liver transplantation can be prevented by administering [[hepatitis B]] [[immune globulin]] at the time of transplantation. There is no established role for [[Prophylaxis|prophylactic]] or therapy following transplantation in [[HCV]]. Combination therapy for [[HCV]] may be [[Peginterferon Beta-1a|peginterferon]] or standard interferon and [[ribavirin]], monotherapy may be [[Peginterferon Beta-1a|peginterferon]], standard [[Interferon|interferon,]] or [[ribavirin]], and anti-HCV [[immune globulin]]. | Prognosis is good. One-year [[survival rates]] are 83%, 5-year survival is 76% and 10-year survival is 66%. Mortality rates in donors are 0.2% in the USA and vary from 0.1 to 1.0% worldwide. The risk associated with left-lobe donation may be lower than that with right-lobe donation. Recurrence varies according to the cause; [[hepatitis B virus]] is the commonest cause of recurrence followed by [[hepatitis C]] virus. Recurrence of [[Hepatitis B virus|HBV]] after liver transplantation can be prevented by administering [[hepatitis B]] [[immune globulin]] at the time of transplantation. There is no established role for [[Prophylaxis|prophylactic]] or therapy following transplantation in [[HCV]]. Combination therapy for [[HCV]] may be [[Peginterferon Beta-1a|peginterferon]] or standard interferon and [[ribavirin]], monotherapy may be [[Peginterferon Beta-1a|peginterferon]], standard [[Interferon|interferon,]] or [[ribavirin]], and anti-HCV [[immune globulin]]. | ||
Revision as of 23:30, 19 December 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
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Liver trasnsplantation Microchapters |
Overview
Liver transplantation indications
Indications for liver transplantation include acute liver failure, cirrhosis, Liver neoplasms, and metabolic disorders such as Familial amyloid polyneuropathy, Primary hyperoxaluria, Cystic fibrosis, alpha-1 antitrypsin deficiency, glycogen storage disease, tyrosinemia, hemochromatosis, Wilson disease, and Acute intermittent porphyria.
Pre-surgical management
Pre-surgical management for liver transplantation includes laboratory testings such as ABO-Rh blood typing, Liver biochemical and function tests (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, bilirubin, international normalized ratio, complete blood count, creatinine clearance,serum sodium, serum alpha-fetoprotein, and calcium and vitamin D levels. Cardiological testings include electrocardiogram, cardiac stress testing, echocardiography , pulse oximetry and ABG.
Prognosis
Prognosis is good. One-year survival rates are 83%, 5-year survival is 76% and 10-year survival is 66%. Mortality rates in donors are 0.2% in the USA and vary from 0.1 to 1.0% worldwide. The risk associated with left-lobe donation may be lower than that with right-lobe donation. Recurrence varies according to the cause; hepatitis B virus is the commonest cause of recurrence followed by hepatitis C virus. Recurrence of HBV after liver transplantation can be prevented by administering hepatitis B immune globulin at the time of transplantation. There is no established role for prophylactic or therapy following transplantation in HCV. Combination therapy for HCV may be peginterferon or standard interferon and ribavirin, monotherapy may be peginterferon, standard interferon, or ribavirin, and anti-HCV immune globulin.