Liver Transplant

Question 1

What is a orthotopic transplant?

Answer 1

Entire liver transplanted from a healthy person that has just died

Question 2

What is a living donor transplant?

Answer 2

Liver is able to regenerate

Portion of the liver is taken from a living donor and transplanted into patient

Both regenerate becoming two full organs

Question 3

What is split donation?

Answer 3

Liver of deceased person split into two and transplanted into two people

Liver then regenerates to normal size

Question 4

What are the indications for liver transplant?

Answer 4

Acute liver failure
Requires immediate transplant
Acute viral hepatitis or paracetamol overdose

Chronic liver failure
Can wait for transplant for period of time
Usually ~5 months

Certain cases of hepatocellular carcinoma

Question 5

What factors make a person unsuitable for liver transplantation?

Answer 5

Significant co-morbidities

Current illicit drug use

Continuing alcohol misuse

Untreated HIV

Current or previous cancer

Question 6

What incision is made for liver transplantation surgery?

Answer 6

Rooftop

or

Mercedes Benz

Both along lower costal margin

Question 7

What drugs are given post-transplantation?

Answer 7

Immunosuppressants:
- Steroids
- Azathioprine
- Tacrolimus

Question 8

What lifestyle advice and monitoring do post-transplantation patients need?

Answer 8

Avoid alcohol and smoking

Treat opportunistic infection

Monitoring for disease recurrence

Monitoring for cancer- significantly higher risk in immunosuppressed patients

Question 9

How is liver transplant rejection monitored?

Answer 9

Abnormal LFTs

Fatigue

Fever

Jaundice