Endoscopic management of the liver transplant patient.
The endoscopic evaluation of the asymptomatic liver transplant patient is essential to risk-stratify the patient for future complications related to portal hypertensive bleeding (i.e., presence of large varices), and to exclude findings (e.g., malignancy) that might preclude the patient from consideration of OLT. Because waiting times for transplant are longer after listing, preventive management becomes imperative to diminish attrition on the waiting list and maintain long-term success. Following OLT, endoscopy may be performed to assess a number of common problems: gastrointestinal blood loss that may be caused by anastomotic lesions; persistent portal hypertensive bleeding; biliary complications, including leaks and strictures; and systemic processes (e.g., infectious diseases or lymphoproliferative disorder (LPD). Clearly, endoscopy plays an integral role in the successful management of the patient before and after OLT.
Donovan
J P
JP
Department of Internal Medicine, Creighton University Medical Center, Omaha, Nebraska, USA.
D016145:Endoscopy, Digestive System; D006801:Humans; D016031:Liver Transplantation; D011183:Postoperative Complications / Q000175:diagnosis; D011300:Preoperative Care