Liver Transplantation ✅ Flashcards
What are the categories of indicators for the need for liver transplantation?
- Biochemical
- Symptomatic
- Psychosocial
What are the biochemical indicators for a need for liver transplantation?
- Persistent rise in total bilirubin >150mmol/L
- Prolongation of prothrombin ratio (INR >1.4)
- Fall in serum albumin <35g/L
What are the symptomatic indicators of a need for liver transplantation?
- Chronic hepatic encephalopathy
- Refractory ascites
- Recurrent variceal bleeding despite optimum managemenet
- Intractable pruritis
- Severe metabolic bone diseae
What are the psychosocial indicators of a need for liver transplantation?
- Reduction in psychosocial development
- Diminishing quality of life
Why should transplantation be considered early?
Assessment and identification of suitable donor is time-consuming, and need medical preperation
What medical preparation is required for liver transplant?
- Immunisations prior to transplant
- Optimising medical treatment of complications of liver disease, e.g. nutritional support
- Adequate preparation of the child and their family
What is the 1 year survival rate of liver transplantation?
92%
When do most deaths following liver transplantation occur?
Within the first 3 months
What are the most common causes of death following liver transplantation?
Vascular or biliary complications
What % of children with alpha-1-antitrypsin deficiency require transplantation in childhood?
20-30%
When do children with glycogen storage disease type I require liver transplantation?
- Medical management not tolerated
- Development of multiple hepatic adenoma
- Poor quality of life
Which types of glycogen storage disease often result in the need for liver transplantation?
III and IV
