![]() | Only 14 pages are availabe for public view |
Abstract End-stage liver disease is caused by a variety of chronic diseases such as viral hepatitis, biliary cirrhosis, metabolic diseases, alcoholic liver cirrhosis and fulminant hepatic failure. Patients with liver disease will suffer from disturbances in the metabolic, hematological and homeostatic functions as well as portal hypertension and hepatic encephalopathy. Liver transplantation has evolved from a rare and risky operation of questionable therapeutic value to the preferred treatment for extensive list of end-stage liver diseases to save guard them against the harmful effects of end-stage liver disease. Liver transplantation is considered in three phases. The pre-anhepatic phase in which the liver is mobilized, the anhepatic phase in which the liver is removed and may be accompained by veno-venous bypass and the neohepatic phase in which the new liver is reperfused. Postoperative care of patients undergoing liver transplantation is best provided in the intensive care unit. It includes care of respiratory and cardiovascular function, daily investigations, nutritional support and the start of immunesuppression course. Many postoperative complications arise after liver transplantation either technical complications such as hemorrhage, thrombosis of hepatic artery and portal vein, graft dysfunction and biliary tract complications or medical complications such as pulmonary, cardiovascular, hematological, renal failure, infections, malignancy and recurrence. Hoped for but as yet unachieved developments in liver transplantation are hepatocyte transplantation, liver-directed gene therapy and xenotransplantation |