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Saturday, January 19, 2008

Before Surgery

  • Why a Transplant is Necessary

A number of diseases can directly damage the liver. Damage to the liver can seriously affect the absorption of vitamins and nutrients, prevent waste products from being effectively removed from the system, and reduce the production of proteins needed to clot the blood.
If the damage is severe enough, transplantation may be necessary. A transplant provides a patient with a liver that can keep up with the demands of a full, active life.

A number of diseases can directly damage the liver. Damage to the liver can seriously affect the absorption of vitamins and nutrients, prevent waste products from being effectively removed from the system, and reduce the production of proteins needed to clot the blood.
If the damage is severe enough, transplantation may be necessary. A transplant provides a patient with a liver that can keep up with the demands of a full, active life.

  • Pretransplant Evaluation
Pretransplant tests, as well as giving a clear picture of the patient's overall health status, help in identifying potential problems before they occur. They also help in determining whether transplantation is truly the best option. This increases the likelihood of success.
The following procedures help in evaluating a patient's health status:
  1. Chest x-ray - Determines the health of the patient's lungs and lower respiratory tract.
  2. Electrocardiogram (EKG or ECG) - Determines how well the patient's heart is working and may reveal heart damage that was previously unsuspected.
  3. Ultrasound with Doppler examination - Determines the openness of the bile ducts and major vessels. It is commonly done in all liver transplant recipients before and after transplantation.
  4. CT (CAT) scan - This computerized image will show the size and shape of the patient's liver and major blood vessels.
  5. MRI (magnetic resonance imaging) - May be used in place of CT scan or ultrasound to see inside the patient's body.
  6. Total-body bone scan - If the patient has a liver tumor, ensures that it has not spread to his bones.
  7. Blood tests - The patient's blood count, blood and tissue type, blood chemistries, and immune system function will all be checked. In addition, blood tests for certain infectious diseases will be performed.
  8. Pulmonary function test - The patient will be asked to breathe into a tube attached to a measuring device, which will reveal how well his lungs are working and determine his blood's capacity to carry oxygen.
  9. Hepatic angiograph - Dye injected into the patient's arteries will enable the transplant physician to see if there are any abnormalities or blockages in the patient's blood vessels.
  10. Cholangiogram - Reveals any obstructions or growths in the patient's bile ducts.
  11. Gallium, colloidal gold, or technetium scan - Gives the transplant physician a view of the patient's liver, gallbladder, and pancreas.
  12. Peritoneoscopy - By inserting a flexible tube through a tiny incision in the patient's abdomen, the transplant physician will be able to see any structural changes in the liver.
  13. Upper gastrointestinal (GI) series - This will show whether the patient's esophagus and stomach are disease free.
  14. Lower GI series - Ensures that the patient is free of intestinal abnormalities.
  15. Renal function studies - Urine may be collected from the patient for 24 hours in order to determine if the kidneys are working correctly। Blood tests such as serum creatinine are also performed to measure kidney function.
  • The Transplant Team

  1. Transplant Surgeon
  2. Transplant Physician (Hepatologist)
  3. Transplant Coordinator
  4. Nurse Practitioner
  5. Floor or Staff Nurse
  6. Physical Therapist
  7. Dietician
  8. Psychologist / Psychiatrist
  9. Social Worker
  10. Pharmacist
Each of the skilled health care professionals who make up the transplant team take a personal interest in answering a patient's questions and taking care of his medical needs. They will also help the patient keep his spirits up along the way.
The patient is the most important member of the transplant team. To a certain extent, all the other team members will respond to his cues. The patient's physical, emotional, and practical needs will help them shap
  • Preparing and Waiting for a Transplant
Days and weeks may pass while the transplant team waits for ORBO to locate the right liver for a specific patient. During this time, the patient should prepare as much as possible and take positive steps to deal with the stresses of waiting, always staying focused on reaching the goal of transplant.
  1. The Telephone as a Lifeline
  2. Make a List and Pack Ahead of Time

  3. Getting to the Transplant Center
  4. Dealing with Pretransplant Stress
Via:USC

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