RT Journal Article
SR Electronic
T1 Adult liver transplantation: UK clinical guideline - part 2: surgery and post-operation
JF Frontline Gastroenterology
JO Frontline Gastroenterol
FD BMJ Publishing Group Ltd
SP 385
OP 396
DO 10.1136/flgastro-2019-101216
VO 11
IS 5
A1 Charles Millson
A1 Aisling Considine
A1 Matthew E Cramp
A1 Andrew Holt
A1 Stefan Hubscher
A1 John Hutchinson
A1 Kate Jones
A1 Joanna Leithead
A1 Steven Masson
A1 Krish Menon
A1 Darius Mirza
A1 James Neuberger
A1 Raj Prasad
A1 Anthony Pratt
A1 Wendy Prentice
A1 Liz Shepherd
A1 Ken Simpson
A1 Doug Thorburn
A1 Rachel Westbrook
A1 Dhiraj Tripathi
YR 2020
UL http://fg.bmj.com/content/11/5/385.abstract
AB Survival rates for patients following liver transplantation exceed 90% at 12 months and approach 70% at 10 years. Part 1 of this guideline has dealt with all aspects of liver transplantation up to the point of placement on the waiting list. Part 2 explains the organ allocation process, organ donation and organ type and how this influences the choice of recipient. After organ allocation, the transplant surgery and the critical early post-operative period are, of necessity, confined to the liver transplant unit. However, patients will eventually return to their referring secondary care centre with a requirement for ongoing supervision. Part 2 of this guideline concerns three key areas of post liver transplantation care for the non-transplant specialist: (1) overseeing immunosuppression, including interactions and adherence; (2) the transplanted organ and how to initiate investigation of organ dysfunction; and (3) careful oversight of other organ systems, including optimising renal function, cardiovascular health and the psychosocial impact. The crucial significance of this holistic approach becomes more obvious as time passes from the transplant, when patients should expect the responsibility for managing the increasing number of non-liver consequences to lie with primary and secondary care.