TITLE:
Analysis of critical issues in case management for liver retransplantation
AUTHORS:
Marina Moguilevitch, Ellise Delpin
KEYWORDS:
Liver Retransplantation; TEE in Liver Transplantation; Monitoring in Liver Retransplantation; Anesthetic Management Liver Retransplantation
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.2 No.9,
December
13,
2013
ABSTRACT: We report a case of a
patient who underwent successful combined liver-kidney transplant after two
prior liver transplantations. The topic of liver retransplantation is very
controversial. Given the critical organ shortage, the question arises as to whether hepatic retransplantation should be offered liberally despite its greater cost, and inevitable denial of
access to primary transplantation for the other patients on the waiting list. We
suggest that careful selection of the retransplant candidates will improve outcomes
and allow rational use of the limited organ
supply. Analysis of the available literature allows us to identify the
main predictors of morbidity and mortality for this patient population. It also
enables development of a detailed plan for perioperative management. The role
of transesophageal echocardiography (TEE) as a monitor in the complex liver
transplant cases is also discussed. Our report is a significant contribution to
the very limited data available on the subject of multiple liver retransplants.