ANSWERS RATED 100% CORRECT!!
Absolute Contraindications for liver transplant
Severe cardiopulmonary disease, uncontrolled HIV, poorly controlled Psych illness,
noncompliance, anatomical abnormalities precluding adequate surgical reconstruction
Reason for not accepted for liver TX
Hepatocellular Carcinoma (HCC) outside Milan Criteria
What is NAFLD?
Nonalcoholic Fatty Liver Disease- caused by obesity, hyperglycemia, elevated serum
lipids, and high BP
What is NASH?
Non-alcoholic steatohepatitis. Can lead to cirrhosis 3rd common indication for liver TX.
What is the MELD score?
MELD(Model for End Stage Liver Disease) is a predictive model of death within a 3
month period. Ranks your degree of sickness, shows how much you need a liver
transplant. The higher the number, the more urgent case is. Score ranges from 6-40.
*Score for HCC capped at 34.
Calculated using:
-INR
-Bilirubin
-Creatinine
-Sodium
MELD > 14 needed for liver transplant
What can green drainage post liver TX indicate?
Bile leakage
What can a rise in ALP post liver tx indicate?
Can be a sign of biliary complications or cholestasis
Lab changes are indicate of graft dysfunction. Which values will be elevated for
liver tx?
Elevated AST and ALT
Target levels for immunosuppressants are based on a number of factors
including:
Indication for tx, use of induction therapy, kidney function, overall condition of pt.
What can lead to metabolic encephalopathy post liver transplant?
Renal failure or sepsis
What can lead to hypoxic ischemic encephalopathy post liver transplant?
Significant peri-operative hypotension
De Novo seizures can occur post liver transplant and can be caused by what?
Electrolyte imbalances, reaction to cyclosporine or tacrolimus, intracranial hemorrhage
or cerebral infarction and intracerebral abscesses
What can cause a post liver transplant patient whose initial postop neurological
course is normal to develop sudden deterioration in neurological status?