Primary care management of the liver transplant patient

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

The patient referred for liver transplantation typically has complications from a progressive, irreversible liver injury. Less traditional complications of end-stage liver disease, such as bone disease and some hepatobiliary malignancies, may also prompt referral. However, there are contraindications to liver transplantation, such as metastatic malignancy and persistent substance abuse. Each patient should be referred as early as possible. The evaluation process includes a complete physical examination and social and psychological evaluations. If transplantation is agreed upon, the patient is listed by clinical status and enters a waiting period for a donor liver. Following transplantation, the patient is maintained on a regimen of immunosuppressive drugs to prevent allograft rejection. Each patient is also maintained on prophylactic medications, to decrease the risk of opportunistic infection. Many of the postoperative problems in liver transplantation are a result of immunosuppression, either as side effects of the medications used to prevent and control rejection or from the intensity of resulting immunosuppression. These problems include headaches, systemic hypertension, acute and chronic allograft rejection, renal dysfunction, opportunistic infection with cytomegalovirus or Pneumocystis carinii, disease recurrence, and neoplasia. Routine, long-term care includes systematic clinical follow-up and repetitive blood tests. Communication among the transplant center, the patient, and the referring physician are essential to a successful outcome over the long term.

Original languageEnglish (US)
JournalThe American journal of medicine
Volume96
Issue number1 SUPPL. 1
DOIs
StatePublished - Jan 17 1994

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Primary Health Care
Transplants
Liver
Liver Transplantation
Opportunistic Infections
Immunosuppression
Allografts
Transplantation
Pneumocystis carinii
Neoplasms
End Stage Liver Disease
Bone Diseases
Hematologic Tests
Long-Term Care
Immunosuppressive Agents
Cytomegalovirus
Physical Examination
Substance-Related Disorders
Headache
Referral and Consultation

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Primary care management of the liver transplant patient. / Zetterman, Rowen K.

In: The American journal of medicine, Vol. 96, No. 1 SUPPL. 1, 17.01.1994.

Research output: Contribution to journalArticle

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