• Indications for liver transplant include chronic viral hepatitis, alcoholic liver disease, congenital biliary abnormalities (biliary atresia), inborn errors of metabolism, HCC (confined to the liver), NAFLD, and acute hepatic failure.
• Postoperative complications of liver transplant include bleeding, rejection, and infection.
• The patient who has had a liver transplant requires highly skilled nursing
Liver disease related to chronic viral hepatitis is the leading dindication for liver transplantation. Other indications: congential biliary abnormalities (biliary atresia), inborn errors of metabolism, livercancer, sclerosing cholangitis, acute liver failure and chronic end stage liver disease.
Liver transplant candidates must o through a rigiourous presurgery screening: to confirm diagnosis of endstage liver disease and to assess for other comorbdidies (cardioascular disease, chronic kkidney diseas)
Contradindications for liver transplant incllude severe extrahepatic disease, advanced hepatocellular carcinoma or other cancer, ongoing drug or alcohol abuse, and inability to comprehend or ocmply with the rigourous postransplant course. because of the scarcity of abialable livers, a donor liver may be divided into two parts (split liver transplant) and implanted into two recipeients.
Immunosuppressive therapy generally involves a combination of corticosteroids (prednisone), a calcineurin inhibitor (cyclsprine or tacrolimus) and an antiproliferative agnt (azathioprine).
Tacrolimus appears to be superior to cyclosporine in liver traansplantantion.
- The pt who has had a transplant requires highly skilled nursing care (ICU): post op nursing care: asssessing neuro status, monitoring for signs of hemorrhage, preventing pulmonary complications, monitoring drainage, electolyte lev es, urine output, and monitoring for signs and symptoms of infection and rejection.
- => commong resp problems: pneumonia, atelectasis, pleural effusions. TCDB, IS, repositioning.
- => measuring the drainage
- =First two months critical for montitoring infection. Can be viral, fungal or bacterial.
Approximately 78% of pts survive more than 5 years after a liver transplant. Describe the collaborative care of the patients undergoing liver transplant.