Practice of Liver Transplantation

SECTION 1 ORGANISATION of SERVICE: The Role of the Transplant Co-Ordinator. Priority and UKTSSA. Retrieval Teams and National Organisation. SECTION 2 SELECTION of PATIENTS and PREOPERATIVE MANAGEMENT: General Considerations in Selection and Management of Patients. Cholestatic Liver Disease. Autoimmune Chronic Hepatitis, Cryptogenic Cirrhosis, Chronic Viral Hepatitis. Alcoholic Liver Disease. Hepatic Malignancy, Budd-Chiari Syndrome and Space-Occupying Indications. Haemochromatosis, Wilson's Disease and Hepatic Enzyme Defects in Adults. Disorders of Infancy and Childhood. Acute Liver Failure. SECTION 3 ANAESTHESIOLOGY and PERIOPERATIVE PERIOD: Anaesthesia and Intraoperative Management. Transfusion and Haemostatic Requirements SECTION 4 SURGICAL TECHNICQUES and ORGANISATION: Donor Operation and Organ Preservation. Standard Orthotopic Operation, Retransplantation and Piggy-Backing. Surgical Techniques of Segmental Reduction, Split and Auxiliary Liver Transplantation. Living-Related Liver Donation SECTION 5 POST-TRANSPLANT CARE and IMMUNOSUPPRESSION: Management of Patient Including Infective Problems. Specific Problem of Cytomegalovirus Infection. Types of Rejection and Immunosuppression. Major Biliary Tract and Vascular Complications. Laboratory Monitoring of Drug Levels and Drug Interactions. Use of Liver Biopsy SECTION 6 LONG-TERM OUTCOME and FOLLOW-UP: Disease Recurrence (Viral and Other Disorders). Overall Survival Results, Quality of Life and Management SECTION 7 PROTOCOLS of MANAGEMENT: Antibacterial and Antifungal Regimes. Nutritional Status and Supplementation. Drug Prescribing and Costs. Technical Procedures in Ventilatory, Circulatory and Renal Support, ICP Monitoring