Skip to main content
Top
Published in: Intensive Care Medicine 3/2019

01-03-2019 | Liver Transplantation | Editorial

10 tips for intensive care management of transplanted liver patients

Authors: Samir Jaber, Audrey De Jong

Published in: Intensive Care Medicine | Issue 3/2019

Login to get access

Excerpt

Among the 1600 liver transplants in Eurotransplant per year [1], most patients have an event-free and short ICU stay. However, mortality figures around 5% are still reported [2] and morbidity may also be substantial. Centers with higher case volume experience better outcomes, including in-hospital mortality and long-term survival, compared to centers with lower case volume [3]. The main purpose of ICU management after liver transplantation is, besides the general management that is applied after all major abdominal surgery, the prevention or early detection of hepatic complications and the problems related to immunosuppression. This article provides ten tips for ICU management of transplanted liver patients. …
Literature
1.
go back to reference Jochmans I, van Rosmalen M, Pirenne J, Samuel U (2017) Adult Liver Allocation in Eurotransplant. Transplantation 101:1542–1550CrossRef Jochmans I, van Rosmalen M, Pirenne J, Samuel U (2017) Adult Liver Allocation in Eurotransplant. Transplantation 101:1542–1550CrossRef
2.
go back to reference Baganate F, Beal EW, Tumin D, Azoulay D, Mumtaz K, Black SM, Washburn K, Pawlik TM (2018) Early mortality after liver transplantation: defining the course and the cause. Surgery 164:694–704CrossRef Baganate F, Beal EW, Tumin D, Azoulay D, Mumtaz K, Black SM, Washburn K, Pawlik TM (2018) Early mortality after liver transplantation: defining the course and the cause. Surgery 164:694–704CrossRef
3.
go back to reference Yoo S, Jang EJ, Yi NJ, Kim GH, Kim DH, Lee H, Jung CW, Ryu HG. (2018) Effect of institutional case volume on in-hospital mortality after living donor liver transplantation: Analysis of 7073 cases between 2007 and 2016 in Korea. Transplantation Yoo S, Jang EJ, Yi NJ, Kim GH, Kim DH, Lee H, Jung CW, Ryu HG. (2018) Effect of institutional case volume on in-hospital mortality after living donor liver transplantation: Analysis of 7073 cases between 2007 and 2016 in Korea. Transplantation
4.
go back to reference Artru F, Louvet A, Ruiz I, Levesque E, Labreuche J, Ursic-Bedoya J, Lassailly G, Dharancy S, Boleslawski E, Lebuffe G, Kipnis E, Ichai P, Coilly A, De Martin E, Antonini TM, Vibert E, Jaber S, Herrerro A, Samuel D, Duhamel A, Pageaux GP, Mathurin P, Saliba F (2017) Liver transplantation in the most severely ill cirrhotic patients: a multicenter study in acute-on-chronic liver failure grade 3. J Hepatol 67:708–715CrossRef Artru F, Louvet A, Ruiz I, Levesque E, Labreuche J, Ursic-Bedoya J, Lassailly G, Dharancy S, Boleslawski E, Lebuffe G, Kipnis E, Ichai P, Coilly A, De Martin E, Antonini TM, Vibert E, Jaber S, Herrerro A, Samuel D, Duhamel A, Pageaux GP, Mathurin P, Saliba F (2017) Liver transplantation in the most severely ill cirrhotic patients: a multicenter study in acute-on-chronic liver failure grade 3. J Hepatol 67:708–715CrossRef
5.
go back to reference Jung B, Cisse M, Chanques G, Arsac E, Bismuth M, Panaro F, Perrigault PF, Souche B, Gallix B, Verzilli D, Delay JM, Navarro F, Pageaux GP, Jaber S (2011) Causes of early mortality after liver transplantation: a twenty-years single centre experience. Ann Fr Anesth Reanim 30:899–904CrossRef Jung B, Cisse M, Chanques G, Arsac E, Bismuth M, Panaro F, Perrigault PF, Souche B, Gallix B, Verzilli D, Delay JM, Navarro F, Pageaux GP, Jaber S (2011) Causes of early mortality after liver transplantation: a twenty-years single centre experience. Ann Fr Anesth Reanim 30:899–904CrossRef
6.
go back to reference Dotsch TM, Dirkmann D, Bezinover D, Hartmann M, Treckmann JW, Paul A, Saner FH (2017) Assessment of standard laboratory tests and rotational thromboelastometry for the prediction of postoperative bleeding in liver transplantation. Br J Anaesth 119:402–410CrossRef Dotsch TM, Dirkmann D, Bezinover D, Hartmann M, Treckmann JW, Paul A, Saner FH (2017) Assessment of standard laboratory tests and rotational thromboelastometry for the prediction of postoperative bleeding in liver transplantation. Br J Anaesth 119:402–410CrossRef
7.
go back to reference Sang BH, Bang JY, Song JG, Hwang GS (2015) Hypoalbuminemia within two postoperative days is an independent risk factor for acute kidney injury following living donor liver transplantation: a propensity score analysis of 998 consecutive patients. Crit Care Med 43:2552–2561CrossRef Sang BH, Bang JY, Song JG, Hwang GS (2015) Hypoalbuminemia within two postoperative days is an independent risk factor for acute kidney injury following living donor liver transplantation: a propensity score analysis of 998 consecutive patients. Crit Care Med 43:2552–2561CrossRef
8.
go back to reference Arora V, Maiwall R, Vijayaraghavan R, Jindal A, Saggere Muralikrishna S, Kumar G, Jain P, Sarin SK. (2018) Terlipressin is superior to noradrenaline in the management of acute kidney injury in acute on chronic liver failure. Hepatology (Baltimore, Md) Arora V, Maiwall R, Vijayaraghavan R, Jindal A, Saggere Muralikrishna S, Kumar G, Jain P, Sarin SK. (2018) Terlipressin is superior to noradrenaline in the management of acute kidney injury in acute on chronic liver failure. Hepatology (Baltimore, Md)
9.
go back to reference de Haan JE, Hoorn EJ, de Geus HRH (2017) Acute kidney injury after liver transplantation: recent insights and future perspectives. Best Pract Res Clin Gastroenterol 31:161–169CrossRef de Haan JE, Hoorn EJ, de Geus HRH (2017) Acute kidney injury after liver transplantation: recent insights and future perspectives. Best Pract Res Clin Gastroenterol 31:161–169CrossRef
10.
go back to reference Weiss E, Dahmani S, Bert F, Janny S, Sommacale D, Dondero F, Francoz C, Belghiti J, Mantz J, Paugam-Burtz C (2010) Early-onset pneumonia after liver transplantation: microbiological findings and therapeutic consequences. Liver Transpl 16:1178–1185CrossRef Weiss E, Dahmani S, Bert F, Janny S, Sommacale D, Dondero F, Francoz C, Belghiti J, Mantz J, Paugam-Burtz C (2010) Early-onset pneumonia after liver transplantation: microbiological findings and therapeutic consequences. Liver Transpl 16:1178–1185CrossRef
11.
go back to reference Arabi YM, Casaer MP, Chapman M, Heyland DK, Ichai C, Marik PE, Martindale RG, McClave SA, Preiser JC, Reignier J, Rice TW, Van den Berghe G, van Zanten ARH, Weijs PJM (2017) The intensive care medicine research agenda in nutrition and metabolism. Intensive Care Med 43:1239–1256CrossRef Arabi YM, Casaer MP, Chapman M, Heyland DK, Ichai C, Marik PE, Martindale RG, McClave SA, Preiser JC, Reignier J, Rice TW, Van den Berghe G, van Zanten ARH, Weijs PJM (2017) The intensive care medicine research agenda in nutrition and metabolism. Intensive Care Med 43:1239–1256CrossRef
12.
go back to reference Chanques G, Conseil M, Roger C, Constantin JM, Prades A, Carr J, Muller L, Jung B, Belafia F, Cisse M, Delay JM, de Jong A, Lefrant JY, Futier E, Mercier G, Molinari N, Jaber S (2017) Immediate interruption of sedation compared with usual sedation care in critically ill postoperative patients (SOS-Ventilation): a randomised, parallel-group clinical trial. Lancet Respirat Med 5:795–805CrossRef Chanques G, Conseil M, Roger C, Constantin JM, Prades A, Carr J, Muller L, Jung B, Belafia F, Cisse M, Delay JM, de Jong A, Lefrant JY, Futier E, Mercier G, Molinari N, Jaber S (2017) Immediate interruption of sedation compared with usual sedation care in critically ill postoperative patients (SOS-Ventilation): a randomised, parallel-group clinical trial. Lancet Respirat Med 5:795–805CrossRef
13.
go back to reference Maffei P, Wiramus S, Bensoussan L, Bienvenu L, Haddad E, Morange S, Fathallah M, Hardwigsen J, Viton JM, Le Treut YP, Albanese J, Gregoire E (2017) Intensive early rehabilitation in the intensive care unit for liver transplant recipients: a randomized controlled trial. Arch Phys Med Rehabil 98:1518–1525CrossRef Maffei P, Wiramus S, Bensoussan L, Bienvenu L, Haddad E, Morange S, Fathallah M, Hardwigsen J, Viton JM, Le Treut YP, Albanese J, Gregoire E (2017) Intensive early rehabilitation in the intensive care unit for liver transplant recipients: a randomized controlled trial. Arch Phys Med Rehabil 98:1518–1525CrossRef
14.
go back to reference Jaber S, Lescot T, Futier E, Paugam-Burtz C, Seguin P, Ferrandiere M, Lasocki S, Mimoz O, Hengy B, Sannini A, Pottecher J, Abback PS, Riu B, Belafia F, Constantin JM, Masseret E, Beaussier M, Verzilli D, De Jong A, Chanques G, Brochard L, Molinari N (2016) Effect of noninvasive ventilation on tracheal reintubation among patients with hypoxemic respiratory failure following abdominal surgery: a randomized clinical trial. Jama 315:1345–1353CrossRef Jaber S, Lescot T, Futier E, Paugam-Burtz C, Seguin P, Ferrandiere M, Lasocki S, Mimoz O, Hengy B, Sannini A, Pottecher J, Abback PS, Riu B, Belafia F, Constantin JM, Masseret E, Beaussier M, Verzilli D, De Jong A, Chanques G, Brochard L, Molinari N (2016) Effect of noninvasive ventilation on tracheal reintubation among patients with hypoxemic respiratory failure following abdominal surgery: a randomized clinical trial. Jama 315:1345–1353CrossRef
15.
go back to reference Gerth HU, Pohlen M, Tholking G, Pavenstadt H, Brand M, Wilms C, Husing-Kabar A, Gorlich D, Kabar I, Schmidt HH (2017) Molecular adsorbent recirculating system (MARS) in acute liver injury and graft dysfunction: results from a case-control study. PloS One 12:e0175529CrossRef Gerth HU, Pohlen M, Tholking G, Pavenstadt H, Brand M, Wilms C, Husing-Kabar A, Gorlich D, Kabar I, Schmidt HH (2017) Molecular adsorbent recirculating system (MARS) in acute liver injury and graft dysfunction: results from a case-control study. PloS One 12:e0175529CrossRef
Metadata
Title
10 tips for intensive care management of transplanted liver patients
Authors
Samir Jaber
Audrey De Jong
Publication date
01-03-2019
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 3/2019
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-019-05579-0

Other articles of this Issue 3/2019

Intensive Care Medicine 3/2019 Go to the issue