Postoperative care after liver transplantation

The proliferation of liver transplant services across the country during the next 5 years will be an interesting phenomenon to observe. An enlightened approach to the process require answers to several essential questions, many of which are discussed elsewhere in this issue of Seminars. Regardless of how the future distribution of services sorts out, many physicians will face an increasing likelihood that their services will be requested in the long-term management of liver transplant recipients. In this report, the care of liver transplant patients is discussed, including that involving the immediate post-operative phase, the in-hospital recovery, and the early and long-term care of outpatients. The discussion is limited to the more common problems that these patients experience. Information from available literature is interspersed with our experience to provide a personal approach to the diagnosis and treatment of both complications and normal post-transplant clinical concerns. Part of what the reader should obtain from a general review of a complex subject is an awareness of the amount of information that the review does not contain. We have touched the surface of a large number of topics, but have come up far short of a comprehensive coverage of all aspects of the postoperative care of the liver recipient. It is hoped that we have provided enough information to serve the reader as an initial foundation for building a more complete understanding of the management of liver transplant patients.