Lecture 28 - Liver Transplant Flashcards
Three keys to prolonged life and success of liver transplantation were the use of _______ (the first successful immunosuppressor for liver transplant), ________ (an immunosuppressor with fewer side effects), and the University of _______ solution for preserving the donor organ.
Cyclosporine
Tacromilus
University of Wisconsin solution
Acute liver failure is considered when a patient presents with ______ _______ (altered mental status) and _______ (remember the liver produces clotting factors).
Hepatic Encephalopathy
Coagulopathy
Patients with cirrhosis are considered for liver transplant when they develop evidence of hepatic dysfunction measured as ____ > 7 or ____ > 10, OR when they experience their first major complication (e.g. ascites, variceal bleeding, or hepatic ________).
Children should be referred for transplant when they deviate from the normal ____ _____.
CTP > 7
MELD > 10
Hepatic Encephalopathy
Growth Curves
Patients with type 1 _____ syndrome should have expedited referral.
Hepatorenal syndrome
All patients with chronic liver disease should be screened for _______ during liver transplantation eval. Transplantation requires use of steroids, which may worsen the condition.
Osteoporosis
Severe obesity, BMI > ____ - _____, is a contraindication for liver transplant.
35-40
Why are smokers not good candidates for transplant?
The immunosuppression and steroids give post treatment leave them at much greater risk for developing cancer.
Patients with HCC have optimal transplant results if they meet the following criteria:
A SINGLE lesion between ____cm and
_____cm.
OR
No more than ____ lesions, all of which must be less than ____cm.
OR
No radiographic evidence of _______ disease.
2cm and 5cm
OR
3 lesions
3cm
OR
Extrahepatic disease
At what MELD score are patients moved from “Waitlist Advantage” to “Transplant Advantage?”
15 or greater
