Liver Transplantation: Protocol for Recipient Selection, Evaluation, and Assessment.

Area of Science:

• Hepatology and Transplant Surgery
• Gastroenterology
• Internal Medicine

Background:

• Liver transplantation (LT) is the primary treatment for end-stage liver disease, acute liver failure, and liver cancer.
• The adoption and expertise in performing LT are growing in Asia.
• Successful LT hinges on meticulous patient preparation, starting from the initial signs of decompensation in cirrhotic patients.

Purpose of the Study:

• To review the indications and contraindications for liver transplantation.
• To outline the comprehensive evaluation and assessment process for patients with liver disease undergoing LT.

Main Methods:

• Literature review focusing on patient selection and pre-transplant workup for LT.
• Discussion of essential screening protocols, including infectious, cardiac, pulmonology, and psychosocial evaluations.

Main Results:

• LT is indicated for a range of severe liver conditions, including end-stage liver disease, acute liver failure, and hepatocellular carcinoma.
• Contraindications and specific patient-related factors influencing LT candidacy are detailed.
• Comprehensive pre-LT assessment is vital for optimizing patient selection and surgical outcomes.

Conclusions:

• Thorough patient evaluation and preparation are paramount for successful liver transplantation.
• Understanding LT indications, contraindications, and the pre-transplant assessment process is essential for clinicians managing liver disease patients.
• The review provides a framework for assessing patients with liver disease considered for LT.