Liver Transplantation

Question 1

What is compensated CLD?

Answer 1

Patients don’t have any symptoms of the disease
Routinely detected on screening tests
Abnormality of liver function tests

Question 2

What is decompensated CLD?

Answer 2

Jaundice
Ascites
Variceal bleeding
Hepatic encephalopathy

Question 3

Who do we transplant?

Answer 3

Chronic liver disease with poor predicted survival
Chronic liver disease with associated poor quality of life
Hepatocellular carcinoma
Acute liver failure
Genetic diseases

Question 4

What are some contraindications for transplant?

Answer 4

Active extrahepatic malignancy
Active and uncontrolled infection outside of the heaptobiliary system
Active substance or alcohol abuse
Severe cardiopulmonary or other comorbid conditions
Technical and/or anatomical barriers

Question 5

How do we prioritise in ALF?

Answer 5

Acetaminophen-induced ALF and non acetaminophen-induced ALF (paracetamol)

Question 6

How do we prioritise in cirrhosis?

Answer 6

Child’s Pugh scoring A, B and C
MELD score (Bilirubin, Creatinine and INR)
UKELD (Bilirubin, Sodium, Creatinine and INR)

Question 7

What does a MELD score of 50 mean?

Answer 7

0% chance of surviving 3 months

Question 8

What does orthotopic surgery mean?

Answer 8

The new liver is put in the same place as the old one was

Question 9

What is the post operative treatment?

Answer 9

Post operative ITU care
Multidisciplinary care
Prophalactic antibiotics and anti-fungal drugs
Anti-rejection drugs (immunosuppression that prevents rejection)

Question 10

What are the anti-rejection drugs?

Answer 10

Steroids
Azathioprine
Tacrolimus/Cyclosporine