Station 1 - liver transplant patient

Question 1

What scar is seen in a liver transplant patient?

Answer 1

Mercedes-benz / roof top scar

Question 2

What are the top three reasons for liver transplant?

Answer 2

• Cirrhosis
• Acute hepatic failure (hepatitis A and B, paracetamol overdose)
• Hepatic malignancy (HCC)

Question 3

What would you consider for a liver transplant patient with a slate-grey pigmentation?

Answer 3

Slate-grey pigmentation - Haemochromatosis

Question 4

What would you consider for a liver transplant patient with other auto-immune diseases?

Answer 4

Other autoimmune disease - PBC

Question 5

What would you consider for a liver transplant patient with tattoos/needle marks?

Answer 5

Tattoos and needle marks - Hep B / C

Question 6

What external evidence could be found in a patient on ciclosporin?

Answer 6

gum hypertrophy and hypertension

Question 7

What external evidence could be found in a patient on steroids?

Answer 7

Cushingoid appearance, thin skin, ecchymoses

Question 8

Describe success rate of liver transplantation?

Answer 8

80% 1-year survival

70% 5 year survival

Question 9

List causes of gum hypertrophy?

Answer 9

• Cyclosporin
• Scurvy
• Acute myelomonocytic leukaemia
• Pregnancy
• familial

Question 10

Describe skin signs found in transplant patients indicating malignancy?

Answer 10

Dysplastic change - actinic keratosis
SCC (100X inc. risk and multiple lesion)
BCC and malignant melanoma (10X inc. risk)

Question 11

Describe skin signs found in transplant patients indicating infection?

Answer 11

Viral warts

Cellulitis