Liver Transplant

Question 1

What is an orthotopic liver transplant?

Answer 1

entire liver is transported from a deceased donor to a recipient

Question 2

What is a living donor liver transplant?

Answer 2

take a portion of the organ from a living donor, transplant it into a patient and have both regenerate to become two fully functioning organ as the liver can regenerate

Question 3

What is a split donation liver transplant?

Answer 3

split the organ of a deceased person into two and transplant it into two patients and have them regenerate to their normal size in each recipient

Question 4

What are the indications for a liver transplant? (3)

Answer 4

• acute liver failure = requires immediate liver transplant .: placed at top of transplant list
○ E.g. Acute viral hepatitis + paracetamol overdose

• chronic liver failure = can wait longer for their liver transplant and are put on a standard transplant list. Takes around 5 months for a liver to become available 

They may also be used in specific cases of hepatocellular carcinoma.

Question 5

What are some contraindications for a liver transplant? (5)

Answer 5

• Significant co-morbidities (e.g., severe kidney, lung or heart disease)
• Current illicit drug use
• Continuing alcohol misuse (generally 6 months of abstinence is required)
• Untreated HIV
• Current or previous cancer (except certain liver cancers)

Question 6

What types of incisions are used in a liver transplant? (2)

Answer 6

Rooftop
Mercedes Benz

Question 7

What vessels and ducts are anastomosed in a liver transplant? (4)

Answer 7

IVC
Hepatic artery
Portal vein
CBD

Question 8

What medication is required after a liver transplant?

Answer 8

• Patients will require lifelong immunosuppression (e.g., steroids, azathioprine and tacrolimus) and careful monitoring of these drugs.

Question 9

What needs to be monitored for evidence of liver transplant rejection? (4)

Answer 9

○ Abnormal LFTs
○ Fatigue
○ Fever
○ Jaundice