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Perioperative Management of the Liver Transplant Recipient
David J Kramer1, Eric M Siegal1, Sarah J Frogge2
1Aurora Critical Care Service, Advocate Aurora Health Care, 2901 W Kinnickinnic River Parkway, Suite 305, Milwaukee, WI 53215, USA; Department of Medicine, University of Wisconsin School of Medicine and Public Health in Madison, 750 Highland Avenue, Madison, WI 53726, USA.
Abstract:
Perioperative management of the liver transplant recipient is a team effort that requires close collaboration between intensivist, surgeon, anesthesiologist, hepatologist, nephrologist, other specialists, and hospital staff before and after surgery. Transplant viability must be reassessed regularly and particularly with each donor organ. Regular discussions with patient and family facilitate realistic determinations of goals based on patient aspirations and clinical realities. Early attention to hemodynamics with optimal resuscitation and judicious vasopressor support, respiratory care designed to minimize iatrogenic injury, and early renal support is key. Preoperative and postoperative nutritional support and physical rehabilitation should remain a focus.
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