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Medical Course and Complications After Liver Transplantation

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Psychosocial Care of End-Stage Organ Disease and Transplant Patients

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Abstract

Liver transplantation is a definitive treatment for several acute and chronic hepatitides, hepatic malignancies, and metabolic disorders affecting the liver. The technique has blossomed from a rare happenstance in the past to a routine surgery performed regularly in major medical centers all across the developed and developing world. Although liver transplant helps to prolong patient survival, the posttransplant course is fraught with various complications that may occur as a result of immediate or late effects of surgery or chronic cumulative effects of immunosuppressive regimen. Despite the ever-increasing number of liver transplants performed each year, the demand far exceeds the supply of available livers, and wait list morbidity and mortality continue to remain substantial. This chapter describes medical course after liver transplantation, including the major complications and their management.

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Abbreviations

AASLD:

American Association for the Study of Liver Diseases

ACEI:

Angiotensin-converting enzyme inhibitor

ACR:

Acute cellular rejection

AKI:

Acute kidney injury

ARB:

Angiotensin receptor blocker

AST:

Aspartate aminotransferase

ATG:

Antithymocyte globulin

BTA:

Biliary tract abnormality.

CAUTI:

Catheter-associated urinary tract infection.

CKD:

Chronic kidney disease.

CLABSI:

Central line-associated bloodstream infection.

CMV:

Cytomegalovirus

CNI:

Calcineurin inhibitor

CT:

Computed tomography

DCD:

Donation after cardiac death

DDLT:

Deceased donor liver transplant

DEXA:

Dual-energy X-ray absorptiometry

dTaP:

Diphtheria, tetanus, acellular pertussis

EBV:

Epstein-Barr virus

ENT:

Ear, nose, throat

ERC:

Endoscopic retrograde cholangiography

ERCP:

Endoscopic retrograde cholangiopancreatography

ESRD:

End-stage renal disease

HAT:

Hepatic artery thrombosis

HbA1c:

Hemoglobin A1c

HCV:

Hepatitis C virus

HIV:

Human immunodeficiency virus

HLA:

Human leukocyte antigen

HPV:

Human papillomavirus

HRQoL:

Health-related quality of life

ICU:

Intensive care unit

IL-2:

Interleukin-2

INR:

International normalized ratio

IVC:

Inferior vena cava

LDL:

Low-density lipoprotein

LDLT:

Living donor liver transplant

LT:

Liver transplant

MHC:

Major histocompatibility complex

MRCP:

Magnetic resonance cholangiopancreatography

MRI:

Magnetic resonance imaging

mTOR:

Mammalian target of rapamycin

NASH:

Nonalcoholic steatohepatitis

NNRTI:

Non-nucleoside reverse transcriptase inhibitors

PCV13:

Pneumococcal conjugate vaccine 13

PJP:

Pneumocystis jirovecii pneumonia

PNF:

Primary Nonfunction

PPSV23:

Pneumococcal polysaccharide vaccine 23

PTC:

Percutaneous transhepatic cholangiography

PTLD:

Post-transplant lymphoproliferative disorder

PVT:

Portal vein thrombosis

SFSS:

Small-for-size syndrome

SPF:

Sun protection factor

TB:

Tuberculosis

TIPS:

Transjugular intrahepatic portosystemic shunt

UTI:

Urinary tract infection

VAP:

Ventilator-associated pneumonia

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Authors and Affiliations

  1. Division of Transplantation, Methodist University Hospital Transplant Institute/University of Tennessee Health Sciences Center, Memphis, TN, USA

    Rajanshu Verma & Sanjaya K. Satapathy

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  1. Rajanshu Verma
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  2. Sanjaya K. Satapathy
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Correspondence to Sanjaya K. Satapathy .

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Editors and Affiliations

  1. Stanford University School of Medicine, Stanford, CA, USA

    Yelizaveta Sher

  2. Stanford University School of Medicine, Stanford, CA, USA

    José R. Maldonado

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Verma, R., Satapathy, S.K. (2019). Medical Course and Complications After Liver Transplantation. In: Sher, Y., Maldonado, J. (eds) Psychosocial Care of End-Stage Organ Disease and Transplant Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-94914-7_14

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