Care of the Patient with Liver Failure Requiring Transplantation

Chapter

Abstract

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.

Keywords

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

References

  1. 1.
    Yeboah MM. Hepatorenal syndrome. In: Liver disorders. Switzerland: Springer; 2017.Google Scholar
  2. 2.
    Durand F, Graupera I, Gines P, et al. Pathogenesis of Hepatorenal Syndrome: Implications for Therapy. Am J Kidney Dis. 2016;67(2):318–28.CrossRefPubMedGoogle Scholar
  3. 3.
    Gluud LL, Christensen K, Christensen E, et al. Systematic review of randomized trials on vasoconstrictor drugs for hepatorenal syndrome. Hepatology. 2010;51(2):576–84.CrossRefPubMedGoogle Scholar
  4. 4.
    Nadim MK, Durand F, Kellum JA, et al. Management of the critically ill patient with cirrhosis: a multidisciplinary perspective. J Hepatol. 2016;64:717–35.CrossRefPubMedGoogle Scholar
  5. 5.
    Dale CR, Kannas DA, Fan VS, et al. Improved analgesia, sedation and delirium protocol associated with decreased duration of delirium and mechanical ventilation. Ann Am Thorac Soc. 2014;11(3):367–74.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Jakob SM, Ruokonene E, Grounds RM, et al. Dexmedetomidine vs. midazolam or propofol for sedation during prolonged ventilation. JAMA. 2012;307(11):1151–60.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Glanemann M, Hoffmeister R, Neumann U, et al. Fast tracking in liver transplanatation: which patient benefits from this approach? Transplant Proc. 2007;39(2):535–6.CrossRefPubMedGoogle Scholar
  8. 8.
    Futier E, Constantin JM, Paugam-Burtz C, et al. A trial of intraoperative low-tidal-volume ventilation in abdominal surgery. N Engl J Med. 2013;369(5):428–37.CrossRefGoogle Scholar
  9. 9.
    The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342(18):1301–8.CrossRefGoogle Scholar
  10. 10.
    Blackwood B, Burns KE, Cardwell CR, et al. Protocolized versus non-protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients. Cochrane Database Syst Rev. 2014;6(11):CD006904.Google Scholar
  11. 11.
    Bates E, Martin D. Immediate postoperative management and complications on the intensive care unit. Br J Hosp Med. 2017;78(5):273–7.CrossRefGoogle Scholar
  12. 12.
    Gurusamy KS, Pissanou T, Pikhart H, et al. Methods to decrease blood loss and transfusion requirements for liver transplantation. Cochrane Database Syst Rev. 2011;12:CD009052.Google Scholar
  13. 13.
    McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N). J Parenter Enter Nutr. 2016;40(2):159–211.CrossRefGoogle Scholar
  14. 14.
    Plauth M, Cabre E, Riggio O, et al. ESPEN guidelines on enteral nutrition liver disease. Clin Nutr. 2006;25(2):285. Epub 2006 May 16CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Hilmi D, Damian A, Al-Khafaji R, et al. Acute kidney injury following orthotopic liver transplantation: incidence, risk factors and effects on patient and graft outcomes. Br J Anaesth. 2015;114(6):919–26.CrossRefGoogle Scholar
  16. 16.
    Torbenson M, Wang J, Nichols L, et al. Causes of death in autopsied liver transplantation patients. Mod Pathol. 1998;11(1):37.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Paya CV, Wiesner RH, Hermans PE, et al. Risk factors for cytomegalovirus and severe bacterial infections following liver transplantation: a prospective multivariate time-dependent analysis. J Hepatol. 1993;18(2):185.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Memeo R, Piardi T, Sangiuolo F, et al. Management of biliary complications after liver transplantation. World J Hepatol. 2015;7(29):2890–5.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Thuluvath PJ, Pfau PR, Kimmey KB, et al. Biliary complications after liver transplantation: the role of endoscopy. Endoscopy. 2005;37:857–63.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Park JS, Kim MH, Lee SK, et al. Efficacy of endoscopic and percutaneous treatments for biliary complications after cadaveric and living donor liver transplantation. Gastrointest Endosc. 2003;57:78–85.CrossRefPubMedGoogle Scholar
  21. 21.
    Verdonk RC, Buis CI, Porte RJ, et al. Anastomotic biliary strictures after liver transplantation: causes and consequences. Liver Transpl. 2006;12:726–35.CrossRefPubMedGoogle Scholar
  22. 22.
    Verdonk RC, Buis CI, van der Jagt EJ, et al. Nonanastomotic biliary strictures after liver transplantation, part 2: management, outcome and risk factors for disease progression. Liver Transpl. 2007;13:725–32.CrossRefPubMedGoogle Scholar
  23. 23.
    Al-Freah MAB, McPhail MJW, Dionigi E, et al. Improving the diagnostic criteria for primary liver graft nonfunction in adults utilizing standard and transportable laboratory parameters: an outcome-based analysis. Am J Transplant. 2017;17:1255–66.CrossRefPubMedGoogle Scholar
  24. 24.
    Vivarelli M, Burra P, La Barba G, et al. Influence of steroids on HCV recurrence after liver transplantation: a prospective study. J Hepatol. 2007;47:793.CrossRefPubMedGoogle Scholar
  25. 25.
    Klintmalm GB, Davis GL, Teperman L, et al. A randomized, multicenter study comparing steroid free immunosuppression and standard immunosuppression for liver transplant recipients with chronic hepatitis C. Liver Transpl. 2011;17:1394.CrossRefPubMedGoogle Scholar
  26. 26.
    Takada Y, Kaido T, Asonuma K, et al. Randomized, multicenter trial comparing tacrolimus plus mycophenolate mofetil to tacrolimus plus steroids in hepatitis C virus-positive recipients of living donor liver transplantation. Liver Transpl. 2013;19:896.CrossRefPubMedGoogle Scholar
  27. 27.
    O’Grady JG, Hardy P, Burroughs AK, et al. Randomized controlled trial of tacrolimus versus microemulsified cyclosporine (TMC) in liver transplantation: poststudy surveillance to 3 years. Am J Transplant. 2007;7:137.CrossRefPubMedGoogle Scholar
  28. 28.
    Haddad EM, McAlister VC, Renouf E, et al. Cyclosporin versus tacrolimus for liver transplanted patients. Cochrane Database Syst Rev. 2006;4:CD005161.Google Scholar
  29. 29.
    O’Grady JG. Corticosteroid-free strategies in liver transplantation. Drugs. 2006;66:1853.CrossRefPubMedGoogle Scholar
  30. 30.
    Hebert MF, Ascher NL, Lake JR, et al. Four-year follow-up of mycophenolate mofetil for graft rescue in liver allograft recipients. Transplantation. 1999;67:707.CrossRefPubMedGoogle Scholar

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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