This book focuses on patients with end-stage-liver disease (ESLD) who could possibly qualify for liver transplant. This patient cohort raises many problems: who should be treated and also, when is it too late for transplant? The authors are all dedicated experts in the field of ESLD/liver transplantation, but from different disciplines with different views of the problem. In the past 15 years many things have changed in the treatment for these patients: cardiac assessment, treatment of porto-pulmonary hypertension, hemodynamics, coagulation assessment and management, diagnosis of kidney failure, and the timing of dialysis. These issues are comprehensively discussed in this book, in order to provide physicians starting in the field of transplantation an overview of different areas of concern. This book is aimed at specialists and trainees in critical care, hepatology, anesthesia, surgery, and nephrology.
Medical Care of the Liver Transplant Patient looks at monitoring and maintaining the health of organ recipients and donors, pre, during and post-operatively. There are twenty-nine chapters containing practical advice on total patient management. They are arranged into 8 sections and follow the stages of transplantation from first indication and selection of potential recipient, through to acute recovery, long-term follow-up and continued health. In this edition there are new chapters on special considerations in liver transplant patients such as viral hepatitis, alcoholic liver disease and live donor liver transplantation. It also contains the very latest information concerning complications and recurring problems after transplantation. Another new chapter considers fresh approaches and developments in the future. This is a vital reference to all members of the medical team involved at different stages in the care of liver transplantation patients including hepatologists, gastroenterologists, transplant surgeons, specialist nurses, and nutritionists.
This issue of Critical Care Clinics, Guest Edited by Dr. Kenneth McCurry and Dr. Ali Al-Khafaji, focuses on Critical Care of the Solid Organ Transplant Patient. Dr. McCurry’s section of the issue is devoted to Heart and Lung Transplants and includes the following topics: Long term outcomes of transplantation; Mechanical ventilation; Pulmonary hypertension therapy; Extracorporeal membrane oxygenation; Perioperative management of the lung graft following lung transplantation; Perioperative management of the heart graft following heart transplantation; Renal complications following lung and heart transplantation; and Infection and other complications following transplanation. Dr. Al-Khafaji’s section of the issue is devoted to Liver, Kidney, and Small Bowel Transplants and includes the following topics: The immediate postoperative period; Live donor liver transplant; Graft dysfunction and management; Extracorporeal devices; Infectious complication following solid organ transplants; and Cardiac, renal, neurological, and gastrointestinal complications.
Liver Anesthesiology and Critical Care Medicine emphasizes all aspects of this broad and important area and is the definitive textbook for anybody involved in the perioperative care of liver patients. The book is divided into three sections: Physiology and Pathophysiology, Anesthesiology, and Critical Care Medicine. The anesthesiology section contains information about liver transplantation and other liver surgeries and provides detailed practical direction and concise background information of all aspects of the anesthetic management of these patients based on the most recent evidence. The critical care section describes basic critical care management as it relates to liver surgical patients and addresses specific postoperative issues relevant for liver resection and liver transplant patients. The book combines practical guidance to the perioperative management with extensive background and clinical evidence to allow the reader gain an in –depth understanding of this complex and fascinating topic.
Aimed at the trainee surgeon and experienced transplant surgeon, this compendium on split-liver grafting contains articles written by faculty members of the first International Course on Split-Liver Transplantation. It covers the main aspects of the field and is geared towards helping surgeons select the best surgical techniques as well as identifying the pitfalls. The text features detailed instructions on the various procedures as well as an overview of the area.
Saving lives through organ transplantation has become increasingly possible thanks to advances in research and care. Today, the complex field of transplantation continues to develop rapidly, fuelled by demographic change and further evolutions in scientific understanding. The Oxford Textbook of Transplant Anaesthesia and Critical Care has been written and edited by pioneers in the field of organ transplantation with an international team of authors, in order to equip anaesthetists and intensivists with the knowledge and training necessary to provide high quality and evidence-based care. The text addresses fundamentals aspects of scientific knowledge, care of the donor patient, transplant ethics and special considerations. Dedicated sections address each of the major organs; kidney, pancreas, liver, heart and lung, intestinal and multivisceral. Within each organ-based section, expert authors explore underlying disease, planning for transplantation, specialized procedures, perioperative and critical care management as well as post-transplant considerations. Focus points for future developments in transplant immunology are also set out, inspiring current practitioners to engage with current clinical research and help participate in the further advancement of the science of transplantation. The print edition of the Oxford Textbook of Transplant Anaesthesia and Critical Care comes with a year's access to the online version on Oxford Medicine Online. By activating your unique access code, you can read and annotate the full text online, follow links from the references to primary research materials, and view, enlarge and download all the figures and tables.
Explore this practical and step-by-step guide to managing liver transplant patients from leading international clinicians in Hepatology The newly revised Second Edition of Liver Transplantation: Clinical Assessment and Management delivers expert clinical guidance on best practices in managing the care of liver transplant patients. Authors are all experts in their field and cover a world-wide perspective. Organized in an accessible, stepwise fashion and packed with text features such as key points, the book covers all critical areas of each stage of the liver transplant journey, from assessment, to management on the list, to long term care. Readers will learn when to refer a patient for liver transplantation, how to assess a potential liver transplant recipient, learn the principles of the procedure and the long term management of the transplant recipient. Liver Transplantation provides the entire hepatology and surgical team the information required for a sound understanding of the entire procedure, from pre- to post-operative care and management. Clinically oriented and management-focused, the book is far more accessible than the liver transplant sections in traditional hepatology textbooks. Readers will also enjoy: A thorough discussion of when to refer a patient for liver transplantation, including general considerations and the use and abuse of prognostic models An exploration of the selection, assessment, and management of patients on the transplant list, including how to manage a patient with chronic liver disease while on the waiting list A treatment of liver transplantation for acute liver failure (ALF), including assessment and management of ALF patients on the transplant waiting list A discussion of care of the liver transplant recipient after the procedure in the short and long term Perfect for gastroenterologists, hepatologists, and surgeons and other health care professionals managing patients with liver disease who are awaiting, undergoing and following liver transplantation, Liver Transplantation: Clinical Assessment and Management will also earn a place in the libraries of medical students, residents, internal medicine physicians, and GI/Hepatology trainees and all health care professionals providing clinical care to people with liver disease, before, during and after transplantation.
This book focuses on the critical care of the patient with acute, acute on chronic and chronic liver failure as well as the peri-operative care of the patient with liver transplantation. Each of these disease processes is unique in pathophysiological manifestations, underpinnings of physiology and treatment options. Patients with acute, chronic or acute on chronic liver failure are a growing fraction of ICU admissions. Hepatic Critical Care serves as the essential reference for both practicing intensivists at community hospitals and tertiary referral centers. This textbook is also targeted towards trainees specifically interested in taking care of patients with liver disease and liver transplantation.
Providing anesthesiology for liver surgery and especially liver transplantation is highly complex and requires profound expertise in the physiology and pathophysiology of liver disease. This new edition incorporates the latest information in the field and remains the only available book on the topic. It focuses on the practical aspect of liver anesthesiology and critical care, while providing a comprehensive and in depth summary of the knowledge in this field. Most liver transplant centers now have dedicated teams providing anesthesia care during liver transplantations. In the last years there has been a substantial increase in knowledge and improvement in techniques in anesthesiology and critical care of patients undergoing liver surgery and transplant patients. Liver Anesthesiology and Critical Care Medicine, 2nd Edition includes new chapters on chronic liver failure and hepatic cirrhosis, preoperative risk assessment, evidence in liver anesthesiology, the splanchnic and systemic circulation in liver disease and a special focus on analgesia for liver resection including regional techniques. Written for anesthesiologists and critical care physicians caring for patients undergoing liver surgery and transplantation, this book proves to be an essential companion and review book as the number of liver surgeries with higher complexity continue to increase.
A number of areas within liver transplant continue to evolve as the field matures. The advent of increasingly effective therapy for HCV will dramatically reduce the burden of recurrent disease within the next few years. HCC has become a well established indication for transplant with an increasing emphasis on adjuvant therapies to reduce the risk of tumor recurrence and potentially expand the acceptable limits of tumor burden amenable to liver transplant. Renal dysfunction is a frequent complication of decompensated liver disease and an important predictor of diminished post-transplant survival. Newer approached to therapy including terlipressin will reduce the impact of renal dysfunction in liver transplant candidates and potentially reduce the need for combined liver/kidney transplant. Increasing attention is being paid to role of comorbidities such as diabetes and hypertension on long-term recipient outcomes. Retransplantation remains a challenge with a variety of models available to predict outcomes. Cardiac disease pretransplant is an area of active investigation with newer entities such as cirrhotic cardiomyopathy a growing concern. These are some of many evolving issues in liver transplant which will be addressed to update our readers and which in turn will enhance the care of patients with liver disease.
