Liver Transplant Flashcards
What is an orthotopic transplant?
When an entire liver is transplanted from decease patient to recipient
What is a living donor transplant?
When a portion of the liver is taken an transplanted into patient
Due to the liver being a regernative organ meaning it is able to regenerate in both to form a fully functioning organ
What is split donation?
When liver of deceased person split into 2 and transplanted into 2 patients and the transplant is able to regenerate into a fully functioning organ
What are the 2 categories for indication for liver transplant?
Acute liver failure
-acute viral hepatitis
-paracetamol overdose
I.e. patients require immediate transplant and are placed on the top of the transport list
Chronic liver failure
-placed on standard waiting list due to being able to wait longer for a transplant
I.e. takes about 5 months for liver to become available
What factors suggest someone might be unsuitable for a liver transplant?
Significant co-morbidities
Excessive weight loss and malnutrition
Active Hep B, Hep C or other infection
End stage HIV
Active alcohol use
How long must someone abstain from alcohol in order to receive a liver transplant?
At least 6 months
What is transplanted into a liver transplant?
Liver
Biliary system
Blood supply
What scar(s) would indicate someone has had a liver transplant?
Roof top incision
Mercedes Benx incision
What 3 forms of immunosuppression is require after a liver transplant?
Steroids
Azathioprine
Tacrolimus
Aside from immunosuppresion, what else is included in post-transplant care?
Avoid alcohol and smoking
Treat opportunistic infections
Monitoring of disease recurrence
Monitoring for cancer-> increased risk in immunosuppressed patients
What are indications that the transplanted liver might have been rejected?
Abnormal LFTs
Fatigue
Fever
Jaundice
What complications can occur after a liver transplant?
What is the main underlying cause of these complications?
Malignancy Infection Graft failure Hypertension Diabetes Dyslipidaemia CKD
Due to consequence of immunosuppression
What are the possible complications of taking Tacrolimus?
It is a nephrotoxic drug
-taking this drug long term after a transplant can lead to patient developing chronic kidney disease
Where do most livers used for transplant come from?
What is a risker type of donor and why?
Used livers from deceased heart beating donors (DBD)
-means that the liver was being perfused right up to point of retrieval
Donor after circulatory death
-increased risk of ischaemic damage because may have longer period of time between loss of blood supply and retrieval
