Critical care management of the liver transplant recipient.
Liver transplantation is an acceptable treatment modality for complications of end-stage liver disease from chronic and acute liver failure. In the United States, 16 377 people are currently awaiting liver transplant but only 6492 transplantations were performed in 2007. All options for liver transplantation including Model for End stage Liver Disease allocated, expanded criteria deceased donors, and live donor liver transplantation should be discussed with potential recipients on the waitlist to create an early access plan for safe and expeditious transplantation. After transplantation, careful management to avoid complications and intervene early is necessary. Common postoperative complications include graft dysfunction, vascular thrombosis, biliary tract complications, infection, rejection, neurologic injury, electrolyte imbalances, and drug interactions. A multidisciplinary approach to care including the critical care nurse is necessary for successful long-term outcomes.
Center for Liver Disease and Transplantation, New York Presbyterian Hospital, Columbia University, New York, NY 10032, USA. dL349@columbia.edu
Dianne LaPointe
DL
Rudow
Michael J
MJ
Goldstein
D000359:Aftercare; D001660:Biliary Tract Diseases / Q000209:etiology / Q000517:prevention & control; D003422:Critical Care / Q000458:organization & administration*; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control; D004347:Drug Interactions; D006084:Graft Rejection / Q000209:etiology / Q000517:prevention & control; D006498:Hepatectomy; D006801:Humans; D017093:Liver Failure / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods* / Q000451:nursing / Q000706:statistics & numerical data; D019520:Living Donors; D024802:Nurse's Role; D009730:Nursing Assessment; D010351:Patient Discharge; D018579:Patient Selection; D019990:Perioperative Care / Q000379:methods / Q000451:nursing; D040841:Resource Allocation; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D009927:Tissue and Organ Procurement; D014481:United States / Q000453:epidemiology; D014850:Waiting Lists; D014883:Water-Electrolyte Imbalance / Q000209:etiology / Q000517:prevention & control