Liver Transplantation Flashcards
when is liver transplant perfromed
Patients with end-stage liver disease to eliminate the irreversible disease when more conservative medical and surgical treatments have failed
what is the most common transplantation indication
Hepatitis C
what are other indications for liver transplant
Alcoholic liver disease and crypotogenic cirrhosis (especially secondary to chronic active hepatitis) Fulminant active hepatitis Congenital metabolic disorders Sclerosing cholangitis Budd-Chiari syndrome Unresectable hepatoma
when is transplantation usually considered
Only in patients with early-stage hepatocellular carcinoma or neuroendocrine mets
what is the Milan criteria
Guidelines for patients with HCC to receive a transplant
what are bilairy compications associated with transplantation
Sclerosing cholangitis
Biliary sludge and stones
Dysfunction of the sphincter of Oddi
The primary function of sonographic examination
evaluate the portal venous system, hepatic artery, inferior vena cava, and liver parenchymal pattern.
Vascular structures
are assessed for size and patency in the preoperative evaluation.
what should liver parenchyma be examined for
Liver parenchyma should be examined to rule out the presence of hepatic architecture disruption.
what should the sonographer also evaluate
the biliary system and look for dilation and the portosystemic collateral vessels.
Rejection
Most common cause of hepatic dysfunction that is confirmed by clinical diagnosis and liver biopsy
Complications of transplantation
Rejection Thrombosis or leak Biliary strictures Infection Neoplasia
Vascular complications
thrombosis, stricture, and arterial anastomotic pseudoaneurysms.
