Oral management of the patient with end-stage liver disease and the liver transplant patient.
The patient with end-stage liver disease who is in need of a liver transplant should have a pretransplant dental evaluation. Such a patient faces lifelong immunosuppression with an increased risk of infection. This article discusses both the need for control of oral diseases before liver transplantation and guidelines for oral care in the immediately postoperative and long-term transplant patient. Specific indications for antibiotic prophylaxis and antibiotic regimens are presented; in addition, adverse reactions and side effects of immunosuppressant drugs are discussed. Pertinent drug interactions salient to the dental management of patients with end-stage liver disease are reviewed, and specific management recommendations for these patients are presented.
Douglas
L R
LR
Department of Dentistry, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Douglass
J B
JB
Sieck
J O
JO
Smith
P J
PJ
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D003729:Dental Care; D004347:Drug Interactions; D004697:Endocarditis, Bacterial / Q000517:prevention & control; D006084:Graft Rejection / Q000188:drug therapy; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D017093:Liver Failure / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D016031:Liver Transplantation; D009059:Mouth Diseases / Q000517:prevention & control*; D009894:Opportunistic Infections / Q000517:prevention & control; D012307:Risk Factors; D014076:Tooth Diseases / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents