title: Critical care of the end-stage liver disease patient awaiting liver transplantation.
abstract: Patients with end-stage liver disease awaiting liver transplantation frequently require intensive care admission and management due to either complications of liver failure or to intercurrent illness, particularly infection. Mortality in such patients is high and the development of an illness necessitating intensive care unit management can influence transplant candidacy. Specialized support frequently requires hemodynamic support, mechanical ventilation, and renal support. In this review, areas of management of particular importance to patients with end-stage liver disease in the intensive care unit are discussed. These areas are hepatic encephalopathy, infectious diseases, cardiovascular support, mechanical ventilation, renal support and combined transplantation, and decisions regarding delisting. Current knowledge specific to these patients, when available, is discussed, current practice is described, and areas of uncertainty in the evidence are discussed.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA. findlay.james@mayo.edu
authors.forename: James Y
authors.initials: JY
authors.lastname: Findlay
authors.forename: Oren K
authors.initials: OK
authors.lastname: Fix
authors.forename: Catherine
authors.initials: C
authors.lastname: Paugam-Burtz
authors.forename: Linda
authors.initials: L
authors.lastname: Liu
authors.forename: Puneet
authors.initials: P
authors.lastname: Sood
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Tomlanovich
authors.forename: Jean
authors.initials: J
authors.lastname: Emond
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications / Q000628:therapy; D002318:Cardiovascular Diseases / Q000209:etiology / Q000628:therapy*; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D058625:End Stage Liver Disease / Q000628:therapy*; D005355:Fibrosis / Q000628:therapy; D006501:Hepatic Encephalopathy / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units; D016031:Liver Transplantation / Q000379:methods*; D017582:Renal Replacement Therapy / Q000379:methods; D018805:Sepsis / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome