[Therapeutic attitude in adult recipients waiting for liver transplantation]

Any new therapeutic procedure raises the question of its possible interference with a possible liver transplantation. This management must therefore give a change to medical treatments of complications of liver disease without interfering with the possibility of subsequent liver transplantation. The treatment of the complications related to chronic liver disease: gastrointestinal haemorrhage, ascites, ascitic infection are examined from this point of view. The necessity of repeated investigation for hepatocellular carcinoma and the importance of maintaining a correct nutritional status are recalled. The elements of monitoring and treatment which can interfere with the planned transplantation are examined in patients with alcoholic cirrhosis, chronic active viral hepatitis B, sclerosing cholangitis, autoimmune chronic active hepatitis or hepatocellular carcinoma. In fulminant hepatitis, the administration of drugs and any form of clotting factor is prohibited due to the particular risk of altering regular reassessment of the level of consciousness and hepatocellular function. Don't transplant those who are going to recover and don't transplant too late those who are not going to recover.