Artificial Liver Treatment: When and Which One?
Fig. 1 The molecular adsorbent recirculating system (MARS) consists of a blood circuit, an albumin circuit, and a dialysate/filtrate side (With permission, modified from Mitzner et al. 2006) SPAD SPAD…
ABDOMINAL MEDICINE
Role of the Transplant Coordinator
Phases of transplantation Phase 1 Pre-transplant evaluation Phase 2 Patient accepted and listed with UNOS. Now in maintenance or candidacy phase Phase 3 Admitted for transplant procedure and inpatient stay…
Immunology of Liver Transplantation
Fig. 1 Model of T-lymphocyte activation and sites of action for immunosuppressive agents (Reprinted with expressed permission from Russell H. Wiesner) (Wiesner and Fung 2011) In the direct pathway, the…
Fulminant Hepatic Failure: Diagnosis and Management
A. Viral HAV, HBV ± HDV, HEV, HSV, CMV, EBV, HVZ, adenovirus, hemorrhagic fever viruses B. Drugs and toxins Examples: Acetaminophen, CCl4, yellow phosphorus, Amanita phalloides, sulfonamides, tetracycline, herbal remedies, halothane, INH,…
Orthotopic Liver Transplantation: Complications
Fig. 1 Hepatic artery thrombosis Hepatic Artery Stenosis Hepatic artery stenosis (HAS) is not a very common vascular complication post-OLT with a reported incidence of 4–10 % (Duff et al….
Transplant Program Liability and Risk Factors for Litigation
Possible theories of liability for organ transplantation litigation Suits by donor Suits by recipient Suits against transplant center Improper timing of procurement failure to obtain informed consent (understating or failing…
Liver Transplantation in the Third Millennium in North America: The Strategy for Success
Fig. 1 Photograph of first kidney transplant. L–R. Miss Rhodes (Scrub Nurse), Dr. Daniel Pugh (Assistant Surgeon), Dr. Joseph E. Murray, Dr. John Rowbotham (Assistant Surgeon), Dr. Edward B. Gray…
Quality Measure of a Contemporary Liver Transplant Program
Fig. 1 Steps for successful quality plan development and implementation Quality Assessment Beyond the Regulatory Requirement The historical monitoring of just survival outcomes to monitor program quality is outdated and…
Liver Transplantation: Medical Home
Year Version Elements of the program 2003 Physician Practice Connections (PPC) This PCMH precursor recognized use of systematic processes and health IT to: Know and use patient history Follow up…
Regulatory Agencies in Transplantation
Criterion Threshold Observed/expected ˃3 Observed/expected ˃1.5 P value Two-sided P < 0.05 The criteria identified are used to scrutinize a center’s performance and outcomes closely. Oversight is provided by the UNOS Department…
