Critical care of the liver transplant patient: an update.
The unique pathophysiology of patients with end-stage liver disease has important implications for their critical care treatment, particularly in the postoperative state. To gauge hemodynamic parameters and responses, each patient must be carefully evaluated for their place in the clinical spectrum of cirrhosis and portal hypertension. Although the data are limited, the biology of the consequences of liver disease is emphasized by novel treatments of hepatorenal syndrome, portopulmonary hypertension, and hepatopulmonary syndrome. These issues become more relevant with increased adult-to-adult living donor liver transplantation, in which technical considerations may further complicate the general treatment of the postoperative transplant patient.
McGilvray
Ian D
ID
Department of Surgery, Division of General Surgery, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada.
Greig
Paul D
PD
D003422:Critical Care / Q000379:methods*; D016027:Heart Transplantation; D006439:Hemodynamics; D020065:Hepatopulmonary Syndrome / Q000503:physiopathology; D006530:Hepatorenal Syndrome / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D006975:Hypertension, Portal / Q000503:physiopathology / Q000628:therapy; D006976:Hypertension, Pulmonary / Q000503:physiopathology / Q000628:therapy; D008107:Liver Diseases / Q000145:classification / Q000503:physiopathology / Q000628:therapy*; D016031:Liver Transplantation / Q000009:adverse effects / Q000502:physiology; D011183:Postoperative Complications; D011654:Pulmonary Edema / Q000628:therapy; D012121:Respiration, Artificial