Guidelines for Surgical Procedures After Liver Transplantation

Abstract

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

Lateral Access Spine Surgery Following Liver Transplantation: A Report of Two Cases

“…In 1998, Testa et al reported the type and incidence of surgical procedures in 409 patients who had previously undergone liver transplantation [15]. Among these, orthopedic surgeries, including spine surgery (two patients) were performed in 47 patients, and their complication rate was 10.7%.…”

Complications Following Plastic Surgery in Solid Organ Transplant Recipients: A Descriptive Cohort Study

“…Some guidelines exist for surgical intervention in SOTRs, though not specifically in the field of plastic surgery [13][14][15]. In addition, many SOTRs on current immunosuppressive regimens go on to lead relatively normal lives and would like to have access to elective plastic surgery procedures.…”

Anaesthesia for patients with a transplanted organ

“…The overall incidence of surgically treatable diseases after transplantation is rarely reported ( 112). Several reports on more delineated areas show that the need for general surgery is increased, and covers a wide range of operations.…”

“…Periods of acute rejection often precede chronic liver rejection ( 119). In the case of sepsis, omittance of azathioprine and reduction in cyclosporine is recommended ( 112). Advice about immunosuppression management can be obtained from the transplantation centres, even though the patients may have their regular checkups elsewhere.…”