Liver transplantation: indication

Question 1

What is the prognosis of cirrhosis post liver transplant and main treatment for liver failure?

Answer 1

Main treatment is liver transplant, however medically we are now able to reverse liver disease

If you carry out the transplant early survival is much better,, once it gets to 50% then its too late

Question 2

What factors need to be considered in terms of carrying out a liver transplant?

Answer 2

age
co-morbidities
fitness
cardiovascular health

Question 3

What is the general waiting time for liver transplant?

Answer 3

for blood group A, 3-6 months

blood group O have to wait longer

Question 4

What questions needs to be considered when assessing whether a patient is suitable for a liver transplant?

Answer 4

What is the correct diagnosis ?
How good will the prognosis be? - What would the long term (5 yr) outlook be?
Are there special circumstances to consider?
Is the patient fir enough to survive the transplant?

Question 5

Why has there been an increase in liver transplants?

Answer 5

because healthcare professionals in ITU are highly trained to discuss with family members about organ donation 
Additionally DCD (donation after cardiovascular death) has now been allowed
Perfusion - ability to preserve organs for hours

Question 6

Which liver diseases have the highest rates of liver transplant?

Answer 6

alcohol related liver disease
PSC
NASH

Question 7

What happens in acute liver failure?

Answer 7

no liver assist device equivalent to dialysis
approx. 15% of liver transplants performed in UK
super-urgent listing