Liver Transplant

Question 1

What are the indications for liver transplant

Answer 1

Complications of cirrhosis - hepatocellular carcinoma, recurrent variceal haemorrhage, intractable ascites, poor synthetic function
Acute hepatic necrosis - eg. paracetamol poisoning
Metabolic disease - eg. oxalosis

Question 2

What are the different types of liver transplant

Answer 2

Deceased organ donation
Living donor liver transplant
Split donation

*Liver can regenerate itself to normal size

Question 3

What criteria are used for liver transplantation in acute liver failure

Answer 3

Kings College Hospital Criteria

Question 4

What are the two categories of Kings College Hospital Criteria for liver transplantation in ALF

Answer 4

Patients with paracetamol toxicity

Patients with other causes (non-paracetamol)

Question 5

What are the criteria for liver transplant in patients with non-paracetamol causes of ALF

Answer 5

PT over 100s

Or 3 of:-
Age under 10 or over 40
Bilirubin over 300 umols/L
PT over 50s
Jaundice to encephalopathy over 7 days
Unfavourable aetiology (eg. non A/B hepatitis, idiosyncratic drug reaction, halothane hepatitis)

Question 6

What are the criteria for liver transplant in patients with paracetamol toxicity

Answer 6

Arterial pH under 7.3

Or all of:-
PT over 100s
Serum creatinine over 300 umol/L
Grade 3/4 encephalopathy

Question 7

What is liver resection

Answer 7

When the right side of the liver is removed, along with the gall bladder
Normally performed for cancer of the liver