Gastro - Liver Transplant Flashcards
What is an orthotopic transplant?
Entire liver transplanted from deceased donor
Ortho - straight
Topic - in place
What is a living donor transplant?
Liver has ability to regenerate
Portion of liver from living donor is taken and transplanted into patient, both are fully functioning
What is a split donation?
Liver of a deceased person split into two and transplanted into two patients
Both regenerate to function normally
What are the indications for liver transplant?
Acute liver failure
- Requires immediate liver transplant
- Patients placed at the top of the list
- Acute viral hepatitis and paracetamol OD
Chronic liver failure
- Patients wait longer and put on standard transplant list
- Usually around 5 months
Hepatocellular carcinoma
What are the contraindications to liver transplantation?
- Significant co-morbidities (severe kidney, lung or heart disease)
- Current illicit drug use
- Continuing alcohol misuse (need 6 months abstinence)
- Untreated HIV
- Current or previous cancer (except certain liver cancer)
What incisions are made in liver transplants?
Rooftop incision
Mercedes Benz incision
What vessels are anastomosed with the recipient’s vessels?
IVC
Hepatic artery
Portal vein
Common bile duct
In split donation, remaining branches of the donated portion of liver are anastomosed with recipient
What post-transplantation care do patients receive?
Lifelong immunosuppression
- Prednisolone
- Azathioprine
- Tacrolimus
- Cyclosporine
Avoiding alcohol and smoking
Treat opportunistic infections
Monitoring for disease recurrence
Monitoring for cancer
What is monitored for evidence of transplant rejection?
Abnormal LFTs
Fatigue
Fever
Jaundice
