Liver Transplants

What is acute liver failure commonly caused by

drug induced injury

what is the most common reason for liver transplant in united states

cirrhosis due to chronic hepatitis C

What is the second most common cause of liver transplant

alcohol abuse

what is the Milan criteria

Guidelines for transplants with HCC based on size

how do they do a transplant on a cadaver

cholecystectomy is performed on the donor

what happens during a choledochodochostomy

A procedure that sews together the bile ducts

What is a benefit to living donor donation

The transplant may work better faster due to decreased preservation time

why do most recipients receive just one lobe

because the liver will replace itself

Why do you not have to take GB pictures on the donor liver

The donor liver receives a cholecystectomy during surgery

Why do we need to angle correct in the left, right, and main hepatic arteries

to accurately assess for stenosis

what is a low RI an indicator of

proximal stenosis upstream

what is a high RI an indicator for

rejection or congestion

what is the normal common hepatic duct diameter

3-7mm

what is the common bile duct diameter

5-9 mm

what should the hepatic arteries velocity be

less than 200 cm/s

what is the normal RI of the hepatic artery

.50-.70

what are urgent findings

Thrombus, occlusion, and active bleeding

when are fluid collections normal

postoperative

Immediately post op what can happen with the HAs

they can have elevated RIs and may have no diastolic flow

what can happen in the LPV directly post op

reversal of flow

if the main hepatic artery RI is 0.94

rejection

What is the most common cause for liver transplant failure

rejection

when does acute rejection occur

10 days of transplantation

what are symptoms for liver transplant rejection

RUQ pain, fever, tachycardia, hepatosplenomegaly, and ascites

What is encephalopathy

when the liver cannot function and the toxins go to the brain

What is an intrahepatic abscess

localized fluid collections of necrotic inflammatory tissue

What is the most issue at the site of anastomosis

thrombosis and stenosis

why do thrombosis and stenosis happen often at the site of anastomosis

the size difference between the native and transplant vessels

What type of stenosis occurs in only 1% of patients

portal vein stenosis

what is the most common vascular complication of liver transplant

HA thrombosis

In 85% of cases, hepatic infarction is associated with what

hepatic artery complications

what is the sign of infarction

wedge shape

what is the most common biliary complication

Obstruction

are most strictures extrahepatic or intrahepatic

extrahepatic

what are intrahepatic strictures usually caused by

ischemia or cholangitis

where are hematomas most common

perihepatic spaces and near the vascular and biliary anastomoses sites

How are hematomas fixed

they resolve on their own

what are seromas

clear serous fluid collections that are found within first few days

what are lymphoceles

surgical disruption of lymphatic channels caused by lymph fluid leakage

where are leaks most common

biliary tube sie

when bile seeps into the peritoneal cavity, what can form

biloma