Critical Care Management after Adult Liver Transplantation

Akan M.

JOURNAL OF THE TURKISH SOCIETY OF INTENSIVE CARE-TURK YOGUN BAKM DERNEGI DERGISI, vol.15, no.1, pp.1-20, 2017 (ESCI) identifier

  • Publication Type: Article / Review
  • Volume: 15 Issue: 1
  • Publication Date: 2017
  • Doi Number: 10.4274/tybdd.79188
  • Journal Name: JOURNAL OF THE TURKISH SOCIETY OF INTENSIVE CARE-TURK YOGUN BAKM DERNEGI DERGISI
  • Journal Indexes: Emerging Sources Citation Index (ESCI), TR DİZİN (ULAKBİM)
  • Page Numbers: pp.1-20
  • Keywords: Liver transplantation, postoperative period, intensive care, liver failure, CENTRAL VENOUS-PRESSURE, RENAL REPLACEMENT THERAPY, END-EXPIRATORY PRESSURE, ACUTE LUNG INJURY, PULMONARY-ARTERY CATHETER, INTENSIVE-CARE, RISK-FACTORS, BLOOD-LOSS, GASTROINTESTINAL COMPLICATIONS, INTRAOPERATIVE HYPERGLYCEMIA
  • Dokuz Eylül University Affiliated: Yes

Abstract

Critical care management after liver transplantation requires a sophisticated monitoring and multi-disciplinary team work. An experienced team and advanced critical care/hospital facilities are necessary for an ideal critical care treatment today. Critical care management after liver transplantation has shown a rapid development since the introduction of liver transplantation. While one-year survival rate after liver transplantation was 79% in 1998, it raised to 90% in 2008 related to the improvements in preoperative optimization, surgical technique, anesthetic management, organ preservation, critial care and immunosuppressive treatment. Treatment of severe coagulopathy, prompt hemodynamic and respiratory stabilization, early weaning from mechanical ventilation, proper fluid-electrolyte therapy, prevention of graft rejection, protection of renal functions and prophylaxis/treatment of infection are particularly important in critical care management after liver transplantation. As early postoperative period of liver transplantation is a critical phase; close monitoring, stabilization of cardiopulmonary functions, frequent evaluation of graft function, early diagnosis of complications and rapid treatment of extrahepatic organ failure are mandatory in order to reduce mortality/morbidity.