Liver transplantation: current status, complications and prevention

The Journal of Antimicrobial Chemotherapy
J Buckels

Abstract

The results of liver transplantation have improved dramatically over the past 15 years and this has produced a marked increase in demand for the procedure. Perioperative problems due to haemorrhage have been largely solved by surgical experience, the use of veno-venous bypass and careful control of coagulation parameters. Developments in graft preservation with the introduction of University of Wisconsin Solution led to improved early graft function as well as allowing day-time surgery. The number of technical failures and subsequent need for retransplantation have been markedly reduced: many units have almost eradicated failure due to hepatic artery thrombosis, although biliary complications still occur, which can often be managed non-operatively with the help of skilled radiologists using percutaneous techniques. Despite advances in immunosuppression, rejection remains a significant problem with many patients requiring additional high dose therapy with inherent risks of infective complications. In addition to conventional bacterial infections, opportunistic organisms including Pneumocystis carinii, cytomegalovirus and fungi pose a particular problem. Specific protocols for prophylaxis against opportunistic infection have been...Continue Reading

Citations

Mar 3, 2006·Journal of Neurology·Fuat SanerChristoph E Broelsch
Sep 4, 2009·Journal of Neurology·Fuat Hakan SanerChristoph E Broelsch
Dec 19, 2006·Archives of Medical Research·Fuat Hakan SanerChristoph E Broelsch
Jul 9, 2004·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Mark S RobertsLisa Weissfeld
Sep 12, 2006·Transplant International : Official Journal of the European Society for Organ Transplantation·Saboor KhanDarius F Mirza

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