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Liver Transplant Medicine

Liver Transplantation Surgeon - Dr. Harikumar

Liver transplant medicine focuses on treating liver patients pertaining to pre-, peri- and post- liver transplantation. Liver transplantation surgery and its clinical activity has emerged as a distinct focus of professional activity that encompasses various aspects of gastroenterology and hepatology, liver surgery, immunology, pathology, multidisciplinary internal medicine and intensive care. This multidisciplinary clinical activity aims at the best possible and evidence based liver care to facilitate optimization of liver disease patients awaiting liver transplantation.

Liver Transplant patients are treated by an integrated multidisciplinary team comprising of Transplant Surgeons, Hepatologists, Critical Care Specialists, Interventional Radiologists and other Supporting services such as transfusion services, microbiology, histopathology.
Liver transplant intervention is a medico surgical team work. Liver transplant medicine is woven in close cooperation with transplant surgery. The responsibility and accountability of clinical management shifts during the patient’s clinical course: predominantly medical management prior to transplantation, predominantly surgical management in the perioperative phase (Surgery and 3 months post operative period), with reversion to medical management beyond 3 months of transplant surgery. Clinical decisions are taken collectively by the medico-surgical transplant team within the paradigm of cooperative care.
Patient with chronic liver disease before transplant would undergo treatment modalities to manage complications of the liver disease, those related to increased liver pressure, waterlogging , liver brain dysfunction, increased liver pressure adversely affecting health of other organs like kidney, heart, lung and muscles. Carrying out pretransplant evaluation is extremely important to see if transplant is strictly indicated to save life of the patient and also to see if there are any factors in the patient which would predict a poor post transplant success ( contraindications).Last but not the least, preliver transplant assessment throws light on optimization strategies to make the patient fit enough to undergo transplant surgery. Bridging techniques like TIPS to reduce liver pressure and clinical decision making on non surgical/pre transplant management of liver cancer, viz, RFA,TACE, TARE( details given in the section on “Procedures offered”).
Long term survival after liver transplantation depends on regular follow up in transplant hepatology clinic which constantly monitors health of new liver, flow in the blood vessels and biliary system, antirejections medications, prompt treatment of infections. Meticulous management of diabetes, hypertension and raised cholesterol levels adds on to post transplant survival.

Comprehensive Liver Care

Liver Transplantation Surgeon in Kochi

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Frequently Asked Questions

What is liver transplant medicine?

Liver transplant medicine focuses on the comprehensive care of patients undergoing liver transplantation, covering pre-, peri-, and post-transplant management through a multidisciplinary team approach.

Who is involved in the liver transplant process?

The liver transplant team typically includes transplant surgeons, hepatologists, critical care specialists, interventional radiologists, and supporting services like microbiology and pathology.

What does the pre-transplant evaluation entail?

The pre-transplant evaluation assesses the patient’s overall health, identifies complications of chronic liver disease, and determines if the transplant is necessary and safe for the patient.

What are bridging techniques in liver transplantation?

Bridging techniques, such as TIPS (Transjugular Intrahepatic Portosystemic Shunt), are procedures used to manage complications like increased liver pressure and to prepare patients for transplantation.

How is the management divided before and after liver transplantation?

Prior to transplantation, the focus is on medical management, while perioperatively, the emphasis shifts to surgical management. After three months, the responsibility reverts back to medical management.

Why is a multidisciplinary approach important in liver transplantation?

A multidisciplinary approach ensures comprehensive care that addresses all aspects of liver health, improving patient outcomes and facilitating collaborative decision-making throughout the transplant process.

What complications of liver disease are managed before transplantation?

Complications include increased liver pressure, fluid retention, hepatic encephalopathy, and impacts on other organs like the kidneys and heart, which are managed to optimize the patient’s condition for transplant.

What is the importance of long-term follow-up after liver transplantation?

Long-term follow-up is crucial for monitoring liver health, managing immunosuppressive therapy, preventing infections, and addressing complications that may arise post-transplant.

How are complications like infections managed after transplantation?

Patients receive regular monitoring and prompt treatment for infections, alongside management of diabetes, hypertension, and cholesterol to ensure optimal recovery and long-term success.

What role do anti-rejection medications play in post-transplant care?

Anti-rejection medications are vital for preventing the immune system from attacking the transplanted liver, and their proper management is essential for the success of the transplant.

How can patients prepare for liver transplantation?

Patients can prepare by maintaining a healthy lifestyle, managing existing health conditions, attending all pre-transplant appointments, and following their healthcare team’s recommendations.

 

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