Liver Transplantation for Hepatic Failure

Author(s): Luis Augusto Carneiro D`Albuquerque, Andre Ibrahim David, Wellington Andraus, Bernardo Fernandes Canedo, Ivana Schmidtbauer and Silvio Marcio Pegoraro Balzan

Pp: 467-477 (11)

* (Excluding Mailing and Handling)

Abstract

• Patient and graft survival after liver transplantation (LT) has improved over time. Despite the options available to increase the donor pool, the expansion on indications for LT has surpassed the availability of grafts, exacerbating the scarcity of grafts.

• Clinical evaluation of potential recipients is crucial to avoid excessively early LT (with no benefit for patients with a good predicted survival without LT) but also excessively late LT (resulting in poorer outcomes). Timing and methods for organ allocation remain challenging.

• Partial liver grafts (including living-donor and splitted grafts) and marginal grafts represent options to increase the graft pool.

• Postoperative complications after LT remain significant and are mainly related to graft quality, recipient clinical status, immunosuppression, recurrence of hepatic disease, and technical aspects.

• LT in the setting of acute liver failure is uncommon and is accompanied by specific factors related to organ allocation and technical aspects.

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