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Patient selection and preoperative evaluation for transplant surgery
1Department of Anesthesiology and Critical Care Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Anesthesiology Clinics
|November 30, 2013
Summary
Pretransplant evaluations for abdominal organ transplantation are crucial for identifying conditions like coronary artery disease. Optimal management strategies for these conditions in transplant candidates require further research and individualized multidisciplinary decision-making.
Area of Science:
- Transplant Surgery
- Cardiology
- Pulmonology
Background:
- Pretransplant evaluation is essential for abdominal organ transplant candidates.
- Coronary artery disease (CAD) is common in this patient population.
- Optimal CAD management in the peri-transplant period remains undefined.
Purpose of the Study:
- To highlight the importance of pretransplant evaluation for abdominal transplant candidates.
- To address the prevalence and management challenges of coronary artery disease.
- To emphasize screening for portopulmonary hypertension and hepatopulmonary syndrome in liver transplant candidates.
Main Methods:
- Review of current practices and literature regarding pretransplant evaluations.
- Discussion of diagnostic and management strategies for coronary artery disease.
- Consideration of specific conditions in liver transplant recipients.
Main Results:
- Coronary artery disease is a significant comorbidity in abdominal transplant candidates.
- Screening for portopulmonary hypertension and hepatopulmonary syndrome is recommended for liver transplant candidates.
- Identifying patients unlikely to benefit from transplantation is challenging and requires individualized assessment.
Conclusions:
- Comprehensive pretransplant evaluation is vital for optimizing outcomes in abdominal organ transplantation.
- Multidisciplinary discussion and individualized decision-making are necessary for complex cases, particularly regarding patient candidacy and management of comorbidities like CAD.
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