Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jun;5(6):443-50.

Recent advances in liver transplantation for the practicing gastroenterologist

Affiliations

Recent advances in liver transplantation for the practicing gastroenterologist

Ranjan Mascarenhas et al. Gastroenterol Hepatol (N Y). 2009 Jun.

Abstract

Liver transplantation is the definitive therapy for end-stage liver disease of various etiologies as well as acute liver failure and early-stage hepatocellular carcinoma. The Model for End-Stage Liver Disease (MELD) score is essential for organ allocation in the United States. Addition of the serum sodium level to the MELD score is a recent development that helps prognosticate cirrhotic patients with hyponatremia, a commonly seen manifestation of end-stage liver disease. The currently used Milan criteria for hepatocellular carcinoma have been expanded with some success at certain transplant centers, and tumor downstaging prior to transplant is being used more frequently. The tremendous shortage of donor organs continues to be the major limitation of this life-saving therapy. This has led to the use of extended-criteria donors, donation after cardiac death, split liver grafts, and live donor liver transplants. Renal dysfunction following liver transplant requires close monitoring and dose adjustments of immunosuppressive medications. Although most liver transplants in the United States are for chronic hepatitis C infection and its sequelae, hepatitis C virus recurrence is a common problem that is challenging to treat in the post-transplant population.

Keywords: Orthotopic liver transplant; donation after cardiac death; hepatocellular carcinoma; live donor liver transplant; model for end-stage liver disease.

PubMed Disclaimer

Similar articles

Cited by

References

    1. Freeman RB, Jr, Edwards EB. Liver transplant waiting time does not correlate with waiting list mortality: implications for liver allocation policy. Liver Transpl. 2000;6:543–552. - PubMed
    1. Freeman RB, Rohrer RJ, Katz E, Lewis WD, Jenkins R, et al. Preliminary results of a liver allocation plan using a continuous medical severity score that de-emphasizes waiting time. Liver Transpl. 2001;7:173–178. - PubMed
    1. Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33:464–470. - PubMed
    1. Wiesner R, Edwards E, Freeman R, Harper A, Kim R, et al. Model for end-stage liver disease (MELD) and allocation of donor livers. Gastroenterology. 2003;124:91–96. - PubMed
    1. Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, Borg PC. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology. 2000;31:864–871. - PubMed

LinkOut - more resources