Liver/Intestine Transplant Flashcards
(53 cards)
What are the signs of hepatic decompensation?
7 items
- esophageal/gastric variceal bleeding
- bleeding from portal hypertensive gastropathy
- hepatic encephalopathy
- spontaneous bacterial peritonitis
- ascites
- coagulopathy
- hepatocellular carcinoma
Indications for liver transplant include end stage liver disease with signs of what?
Hepatic decompensation
What disease categories are indications for liver transplant?
6 items
- Chronic hepatocellular disease
- Chronic cholestatic disease
- Metabolic liver disease
- Hepatic malignancy
- Acute/Fulminant liver failuire
- Vascular disease
Chronic hepatocellular disease includes what diseases?
4 items
- Hepatitis C (HCV)
- Hepatitis B (HBV)
- Alcoholic Cirrhosis
- Autoimmune Hepatitis (AIH)
Laennec’s Cirrhosis is a type of cirrhosis of the liver associated with alcoholism.
Chronic cholestatic liver disease includes what diseases?
5 items
- Primary Biliary Cirrhosis (PBC)
- Primary Sclerosing Cholangitis (PSC)
- Secondary Sclerosing Cholangitis
- Biliary Atresia
- Progressive Familial Intrahepatic Cholestasis (PFIC)
Metabolic liver disease includes what diseases?
5 items
- Nonalcoholic Steatohepatitis (NASH)
- Wilson’s Disease (acute or chronic)
- Alpha-1 Antitrypsin Deficiency (A1AT)
- Primary Hereditary Oxalosis
- Primary Hemochromatosis
What are the types of Hepatic Malignancies?
3 items
- Hepatocellular carcinoma
- Cholangiocarcinoma
- Hepatoblastoma
Acute liver failure can be caused by drug toxicity. What are the 2 most common drugs?
Acetaminophen, Antibiotics
Acute liver failure can be caused by what Metabolic Disease?
1. NASH
2. Wilson’s Disease
3. A1AT
4. Primary Hemochromatosis
2
Acute Liver Failure can be caused most commonly by what 2 viral processes?
Viral Hepatitis B
Autoimmune Hepatitis
When does fatty liver cause acute liver failure?
During pregnancy
What 2 vascular complications may cause the need for transplant?
Liver
Budd Chiari
Veno-occusive diseases
Budd Chiari = thrombosis of hepatic veins. Gradually leads to cirrhosis. It can lead to acute liver failure if progression is rapid.
AFP is a tumor marker for what hepatic malignancy typically seen in kids?
AFP is a tumor marker for what hepatic malignancy typically seen in adults?
Hepatoblastoma
Hepatocellular carcinoma
Normal range is 10-20 ng/mL
CA 19-9 is a tumor marker for what 2 malignancies?
Cholangiocarcinoma and pancreatic cancer
Normal range is 0-37 units/mL
What do low levels of c-peptide indicate? What about high levels?
Low C-peptide levels: May indicate type 1 diabetes, insulin resistance, or pancreatic damage.
High C-peptide levels: May indicate type 2 diabetes, an insulin-producing tumor, or a medication that stimulates insulin production.
Normal levels are 0.5 - 2 ng/mL
What hepatic malignancy should be ruled out with Primary Sclerosing Cholangitis (PSC)?
Cholangiocarcinoma
What specific testing should be completed for Primary Biliary Cirrhosis and why?
Bone densitometry
To rule out osteoporosis
What lung complication are Alpha-1 Antitrypsin patients at risk for?
Emphysema
What is the purpose of a Blakemore tube?
To stop or slow bleeding from the esophagus and stomach
What is the maximum time a Blakemore tube esaphageal tube should remain inflated?
1. 1 hour
2. 6 hours
3. 12 hours
4. 24 hours
2
This is done to avoid necrosis.
What is the purpose of the gastric lumen of the Blakemore tube?
Aspirate stomach contents
What is a Transjugular Intrahepatic Portosystemic Shunt (TIPS) and why is it done?
A stent placed in the liver to reduce portal HTN
What is a Kasai Procedure and why is it done?
A procedure to connect the liver directly to the small intestine to drain bile.
What is the average time it takes for a liver transplant?
6-10 hours
