Transplantation of the Liver

Rejection After Transplantation

Liver transplantation is recognized as optimal therapy for end-stage liver disease. Results today are excellent, with unadjusted 1-year and 5-year patient survival rates of 88.4% and 73.8%, according to the Scientific Registry of Transplant Recipients (SRTR). The incidence of acute…

Transplant-Related Malignancies

Over the last 20 years, liver transplantation has become an integral part of the treatment of patients with end-stage liver disease. Every year in the United States alone, more than 6000 such procedures are performed with ever-improving outcomes. Improvements in…

Pathology of NonNeoplastic Disease After Transplantation

Liver transplantation has enjoyed tremendous success, in part because of the unique immunological properties of the liver and in part because of the development of new pharmaceutical agents to treat rejection and infection. Fortunately, liver allografts are infrequently lost to…

Histopathology of Liver Transplantation

Liver transplantation is used to treat a broad spectrum of end-stage liver diseases. Hepatitis C virus (HCV) and alcoholic and nonalcoholic fatty liver disease–induced cirrhosis are the leading indications in North America, Europe, and South America, whereas in Asia, hepatitis…

Role of the Posttransplant Clinical Nurse Coordinator

The posttransplant clinical nurse coordinator (PTCNC) is an integral part of the patient care delivery team. The PTCNC is involved in the continuum of patient care that begins postoperatively in the hospital and continues to coordinate this care in the…

Neurological Complications

Liver transplants have become relatively frequent procedures throughout the world, with improving survival rates; this means that physicians, regardless of their specialty, are likely to participate in the care of these inherently complex cases. More than 5,500 people in the…

Neuropsychiatric Complications

Neuropsychiatric complications after liver transplantation are common, with the incidence ranging from 10% to 70% and neuropathological findings common at autopsy. In one of the earliest papers discussing outcomes in liver transplantation, Starzl et al noted a high incidence of acute…

Late Complications and Recurrence of Disease After Transplantation

As outcomes after liver transplantation improve from advances in surgical technique, intensive care, and immunosuppression, patients are living longer. As a result, graft and patient survival are largely now dependent on early recognition and treatment of primary disease recurrence and…

Recurrent Hepatitis C After Transplantation

Complications of chronic hepatitis C, including cirrhosis and hepatocellular carcinoma, remain the most common indication for liver transplantation, accounting for nearly half of all liver transplants in the United States. However, this large group of transplant recipients faces a lower…

Infections After Transplantation

Despite the remarkable surgical advances in orthotopic liver transplantation (OLT) and the development of many effective prophylactic strategies, infection can still be a frequent cause of morbidity and mortality after transplantation. The spectrum and manifestations of these infections are broad…