Critical care management of patients before liver transplantation.
The critical care management of patients before liver transplantation is aimed at optimizing hepatic and extrahepatic organ function before the transplant operation, with a goal to favorably influence perioperative and postoperative graft and patient outcomes. Critical illness in liver disease can present in the context of acute liver failure or acute on chronic liver failure. The differing pathophysiologic processes underlying these 2 types of liver failure necessitate specific approaches to their intensive care management. In their extreme presentations, both types of liver failure present as multiorgan system failure; and therefore, the critical care management of these entities requires a systematic multiorgan system approach to address hepatic and extrahepatic organ dysfunction. This review provides a multiorgan system-based description of critical care management of acute liver failure and acute on chronic liver failure before liver transplantation.
Ford
Ryan M
RM
Division of Gastroenterology and Hepatology, Emory University School of Medicine, Atlanta, GA, USA.
Sakaria
Sonali S
SS
Subramanian
Ram M
RM
D000082:Acetaminophen / Q000633:toxicity; D000111:Acetylcysteine / Q000633:toxicity; D001929:Brain Edema / Q000150:complications; D062787:Drug Overdose / Q000150:complications; D058625:End Stage Liver Disease / Q000601:surgery / Q000628:therapy; D020065:Hepatopulmonary Syndrome / Q000601:surgery / Q000628:therapy; D006706:Homeostasis; D006801:Humans; D017114:Liver Failure, Acute / Q000139:chemically induced / Q000209:etiology / Q000601:surgery / Q000628:therapy; D016031:Liver Transplantation / Q000379:methods*; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods / Q000592:standards*; D016896:Treatment Outcome
D000082:Acetaminophen; D000111:Acetylcysteine