Critical care management of patients before liver transplantation

Abstract The critical care management of patients before liver transplantation is aimed at optimizing hepatic and extrahepatic organ function before the transplant operation, with a goal to favorably influence perioperative and postoperative graft and patient outcomes. Critical illness in liver dise...

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Bibliographic Details
Published in:Transplantation reviews (Philadelphia, Pa.) Pa.), 2010-10, Vol.24 (4), p.190-206
Main Authors: Ford, Ryan M, Sakaria, Sonali S, Subramanian, Ram M
Format: Article
Language:English
Subjects:
Acetaminophen - toxicity
Acetylcysteine - toxicity
Brain Edema - complications
Drug Overdose - complications
End Stage Liver Disease - surgery
End Stage Liver Disease - therapy
Hepatopulmonary Syndrome - surgery
Hepatopulmonary Syndrome - therapy
Homeostasis
Humans
Liver Failure, Acute - chemically induced
Liver Failure, Acute - etiology
Liver Failure, Acute - surgery
Liver Failure, Acute - therapy
Liver Transplantation - methods
Postoperative Period
Preoperative Care - methods
Preoperative Care - standards
Surgery
Treatment Outcome
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Summary:Abstract The critical care management of patients before liver transplantation is aimed at optimizing hepatic and extrahepatic organ function before the transplant operation, with a goal to favorably influence perioperative and postoperative graft and patient outcomes. Critical illness in liver disease can present in the context of acute liver failure or acute on chronic liver failure. The differing pathophysiologic processes underlying these 2 types of liver failure necessitate specific approaches to their intensive care management. In their extreme presentations, both types of liver failure present as multiorgan system failure; and therefore, the critical care management of these entities requires a systematic multiorgan system approach to address hepatic and extrahepatic organ dysfunction. This review provides a multiorgan system–based description of critical care management of acute liver failure and acute on chronic liver failure before liver transplantation.
ISSN:0955-470X
1557-9816
DOI:10.1016/j.trre.2010.05.003