ObjectiveThe first purpose of this study is to identify the types and incidences of surgical procedures in patients who have previously undergone liver transplantation, with particular focus on the complication rates and the lengths of hospital stay. The second purpose is to present the management guidelines for patients with liver transplants at the preoperative, intraoperative, and postoperative stages of surgical procedure.
Summary Background DataThe surgical literature on this issue is scant, and with the growing liver transplant patient population it is not unlikely for any surgery specialist to
ResultsA large proportion of patients (24.2%) underwent some type of surgical procedure 2 to 10 years after liver transplantation. The authors demonstrate that most of the elective procedures can be safely carried out without an increased incidence of complication and without longer hospital stay than the general population. Conversely, emergent procedures are plagued by a greater incidence of complications that not only affectthe function of the liver graft but may nsk the life of the patient. This study shows that elective surgery on patients with liver transplants can be safely performed and that the complication rate and the hospital stay are similar to those of healthy patients. Moreover, once a few simple guidelines are followed, the risk of graft dysfunction is practically nil. However, emergent surgical procedures and procedures on patients with poor functioning grafts are affected by a greater complication rate, which may cause a prolonged postoperative course.
MATERIALS AND METHODSFrom January 1985 to December 1995, liver transplantation was performed in 1085 patients (total surgeries 1218). The 409 study patients were selected because their records were available. These patients were interviewed, and the information collected was added to the information in the Baylor University Medical Center Transplant Research database. The only procedures that were part of the study were performed after discharge from the initial liver transplant
