Journal
JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY
Volume 14, Issue 1, Pages -Publisher
ELSEVIER - DIVISION REED ELSEVIER INDIA PVT LTD
DOI: 10.1016/j.jceh.2023.06.003
Keywords
liver transplantation; pre-transplantation waitlist; peri-transplantation management; acute liver failure
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This review article discusses the challenges and difficulties in managing patients during the peri-transplantation period. It covers different aspects such as the management of underlying cirrhosis and portal hypertension complications, treatment and identification of infections, portal vein thrombosis management, and the management of hepatocellular carcinoma and acute liver failure in the transplantation waitlist. The article also highlights specific concerns for patients in the Asian subcontinent and addresses the issue of delisting from the transplant waitlist.
The management of a patient in the peri-transplantation period is highly challenging, and it is even more difficult while the patient is on the transplantation waitlist. Keeping the patient alive during this period involves managing the complications of liver disease and preventing the disease's progression. Based on the pre -transplantation etiology and type of liver failure, there is a difference in the management protocol. The current review is divided into different sections, which include: the management of underlying cirrhosis and complications of portal hypertension, treatment and identification of infections, portal vein thrombosis management, and particular emphasis on the management of patients of hepatocellular carcinoma and acute liver failure in the transplantation waitlist. The review highlights special concerns in the management of patients in the Asian subcontinent also. The review also addresses the issue of delisting from the transplant waitlist to see that futility does not overtake the utility of organs. The treatment modalities are primarily expressed in tabular format for quick reference. The following review integrates the vast issues in this period concisely so that the management during this crucial period is taken care of in the best possible way.
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