Preparing for liver transplantation
Last reviewed: 23.04.2024
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The patient is prepared for liver transplantation according to a standard procedure. It is necessary to discuss with the patient and his relatives all the details of the forthcoming operation and obtain their consent to it.
Conduct standard clinical, biochemical and serological studies, taken in patients with liver disease.
Determine the blood group, antigens HLA and DR, anti-CMV-and anti-HCV-antibodies, as well as hepatitis B markers.
In patients with malignant tumors, all possible methods are used to exclude metastases.
The hepatic artery should be visualized to detect any anatomical abnormalities, including an abnormal escaping of the hepatic artery and a pre-portal location of the portal vein. You should also visualize the portal and lower vena cava. The selective angiography of the right renal artery is also performed, since the high location of the right kidney not recognized in time can lead to inevitable right-sided nephrectomy. The bile ducts before the operation are examined by cholangiography, which is usually performed endoscopically. Conduct standard ultrasound (ultrasound) and computed tomography (CT). A thorough assessment of the condition of the heart and lungs should include measuring the pressure in the pulmonary veins.
Preoperative preparation for liver transplantation takes approximately 10 days. It includes confirmation of the diagnosis, consultation of a psychiatrist. The patient can expect many months of a suitable donor liver, and intensive psychosocial support is needed during this period.
Vaccinate against HBV, pneumococci and influenza virus.
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