Care of the Patient with Liver Failure Requiring Transplantation

  • Caroline Park
  • Damon Clark


Patients undergo liver transplantation to address chronic liver failure, acute fulminant liver failure, or primary liver cancer. Depending on acuity, patients with decompensated chronic or acute fulminant liver failure generally require preoperative intensive care unit admission to manage organ dysfunction. Those with chronic liver failure are allocated an organ based on waiting list position determined by their local organ procurement organization (OPO). This position is dependent upon blood type and Model for End- Stage Liver Disease (MELD) score. These patients thus are critically ill and require preoperative ICU monitoring and care. Patients with hepatocellular carcinoma (HCC) who require liver transplantation are given a MELD exception and rarely require preoperative ICU care. The patient’s ability to undergo liver transplant in the setting of HCC is determined by the Milan criteria or the University of California, San Francisco (UCSF) criteria.


Liver failure Transplantation Primary liver cancer HCC Preoperative ICU care Decompensated chronic liver failure. 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of Southern California Keck School of Medicine, Keck Hospital, Norris Cancer Hospital and LAC-USC, Department of Surgery, Acute Care Surgery and Surgical Critical CareLos AngelesUSA

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