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Chapter 44 - Liver Transplantation in Children: Post-Transplant Care

from Section V - Other Considerations and Issues in Pediatric Hepatology

Published online by Cambridge University Press:  19 January 2021

By
Estella M. Alonso  and
Riccardo A. Superina
Edited by
Frederick J. Suchy ,
Ronald J. Sokol  and
William F. Balistreri
Edited in association with
Jorge A. Bezerra ,
Cara L. Mack  and
Benjamin L. Shneider
Frederick J. Suchy
Affiliation:
University of Colorado, Children’s Hospital Colorado, Aurora
Ronald J. Sokol
Affiliation:
University of Colorado, Children’s Hospital Colorado, Aurora
William F. Balistreri
Affiliation:
Cincinnati Children’s Hospital Medical Center, Cincinnati
Jorge A. Bezerra
Affiliation:
Cincinnati Children’s Hospital Medical Center, Cincinnati
Cara L. Mack
Affiliation:
University of Colorado, Children’s Hospital Colorado, Aurora
Benjamin L. Shneider
Affiliation:
Texas Children’s Hospital, Houston
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Summary

Management in the early postoperative period requires the coordinated efforts of the transplant team and the pediatric intensive care staff, and other key ancillary services, such as interventional radiology, nephrology and infectious diseases that are frequently involved in the management of these children. Patients with end-stage liver disease undergoing liver transplantation require meticulous medical care in the immediate postoperative period to assure adequate perfusion of the graft and avoid exacerbation of injury to other organ systems. Care should be guided by attention to the pretransplant physiologic state, which might include advanced portal hypertension and compromise to other organ systems, such as seen in hepatorenal or hepatopulmonary syndrome. Specifics of the transplant procedure including information regarding blood loss, challenging vascular anastomosis, and graft function following reperfusion are also essential considerations in the management plan.

Type
Chapter
Information
Liver Disease in Children , pp. 816 - 832
Publisher: Cambridge University Press
Print publication year: 2021

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