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Management on the Liver Transplant Waiting List

Liver Unit Queen Elizabeth Hospital, j.m.neuberger{at}bham.ac.uk

Prior to transplantation, the patient must be closely monitored: 1) to provide prophylaxis for complications of liver disease, 2) to detect new problems, and 3) the ensure patient fitness in order to maximize the outcome transplantation. Complications of end-stage liver disease must be prevented: variceal hemorrhage, spontaneous bacterial peritonitis, renal dysfunction, and hepatocellular cancer. Patients must be current on vaccinations for tetanus-diphtheria, poliomyelitis, influenza, hepatitis B, Hepatitis A, pneumococcus, H. influenzae type b, varicella, and mumps-measles-rubella (MMR). Patients are suspended from the waiting list for intercurrent infections, variceal bleeding, and alcohol use by alcoholics. They are reinstated when these problems are corrected.

Key Words: liver transplantation • transinusoidal pressure gradient • spontaneous bacterial peritonitis

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