[Abdominal Organ Transplantation in Multimorbid Patients]

Overview

Journal Chirurgie (Heidelb)

Specialty General Surgery

Date 2024 Dec 6

PMID 39643669

Authors

Astrid Bauschke

Aladdin Ali-Deeb

Felix Dondorf

Falk Rauchfuss

Oliver Rohland

Utz Settmacher

Affiliations

Soon will be listed here.

Abstract

Patients with an indication for transplantation of abdominal organs often suffer from terminal organ failure with a relevant number of comorbidities. This can be complicated by acute and underlying disease-related events or age-related comorbidities. The diagnostic assignment of symptoms is difficult and the available treatment options have to be adapted. During the evaluation, the waiting time for suitable donor organs and immediately prior to surgery, the treatment team, consisting of the referring physician and the interdisciplinary transplantation team needs to decide whether the transplantation can be performed.

References

Bruns T, Aehling N, Bechstein W, Becker T, Trautwein C, Berg T . [The German Guideline on Liver Transplantation by DGVS and DGAV]. Dtsch Med Wochenschr. 2024; 149(6):290-297. DOI: 10.1055/a-2119-6326. View

de Zwaan M, Erim Y, Kroncke S, Vitinius F, Buchholz A, Nohre M . Psychosocial Diagnosis and Treatment Before and After Organ Transplantation. Dtsch Arztebl Int. 2023; 120(24):413-416. PMC: 10437037. DOI: 10.3238/arztebl.m2023.0087. View

Gines P, Krag A, Abraldes J, Sola E, Fabrellas N, Kamath P . Liver cirrhosis. Lancet. 2021; 398(10308):1359-1376. DOI: 10.1016/S0140-6736(21)01374-X. View

Angeli P, Gines P, Wong F, Bernardi M, Boyer T, Gerbes A . Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites. J Hepatol. 2015; 62(4):968-74. DOI: 10.1016/j.jhep.2014.12.029. View

Jalan R, Saliba F, Pavesi M, Amoros A, Moreau R, Gines P . Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure. J Hepatol. 2014; 61(5):1038-47. DOI: 10.1016/j.jhep.2014.06.012. View

Belli L, Duvoux C, Artzner T, Bernal W, Conti S, Cortesi P . Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: Results of the ELITA/EF-CLIF collaborative study (ECLIS). J Hepatol. 2021; 75(3):610-622. DOI: 10.1016/j.jhep.2021.03.030. View

Sundaram V, Mahmud N, Perricone G, Katarey D, Wong R, Karvellas C . Longterm Outcomes of Patients Undergoing Liver Transplantation for Acute-on-Chronic Liver Failure. Liver Transpl. 2020; 26(12):1594-1602. DOI: 10.1002/lt.25831. View

Linecker M, Krones T, Berg T, Niemann C, Steadman R, Dutkowski P . Potentially inappropriate liver transplantation in the era of the "sickest first" policy - A search for the upper limits. J Hepatol. 2017; 68(4):798-813. DOI: 10.1016/j.jhep.2017.11.008. View

Khurmi N, Chang Y, Steidley D, Singer A, Hewitt W, Reddy K . Hospitalizations for Cardiovascular Disease After Liver Transplantation in the United States. Liver Transpl. 2018; 24(10):1398-1410. DOI: 10.1002/lt.25055. View

10.

Lee M, Wadia S, Yeghiazarians Y, Matthews R, White C, Herrmann H . Cardiology Assessment of Patients Undergoing Evaluation for Orthotopic Liver Transplantation. J Soc Cardiovasc Angiogr Interv. 2024; 2(1):100528. PMC: 11308094. DOI: 10.1016/j.jscai.2022.100528. View

11.

Halliday N, Westbrook R . Liver transplantation: need, indications, patient selection and pre-transplant care. Br J Hosp Med (Lond). 2017; 78(5):252-259. DOI: 10.12968/hmed.2017.78.5.252. View

12.

Izzy M, VanWagner L, Lin G, Altieri M, Findlay J, Oh J . Redefining Cirrhotic Cardiomyopathy for the Modern Era. Hepatology. 2019; 71(1):334-345. PMC: 7288530. DOI: 10.1002/hep.30875. View

13.

Mohebali D, Anagnostopoulos A, Estrada-Roman A, Pavlakis M, Curry M, Gavin M . Cardiovascular Risk Assessment in Renal and Liver Transplant Candidates: A Multidisciplinary Institutional Standardized Approach. Cardiol Rev. 2019; 27(6):286-292. DOI: 10.1097/CRD.0000000000000282. View

14.

Stachel M, Depasquale E . Optimizing cardiac status in the preliver transplant candidate. Curr Opin Organ Transplant. 2023; 29(1):50-55. DOI: 10.1097/MOT.0000000000001119. View

15.

Kumar P, Kim J, Gordin J, Honda H, Suh W, Lee M . Fractional Flow Reserve in End-Stage Liver Disease. Am J Cardiol. 2021; 166:122-126. DOI: 10.1016/j.amjcard.2021.11.031. View

16.

Darstein F, Hoppe-Lotichius M, Vollmar J, Weyer-Elberich V, Zimmermann A, Mittler J . Pretransplant coronary artery disease is a predictor for myocardial infarction and cardiac death after liver transplantation. Eur J Intern Med. 2017; 51:41-45. DOI: 10.1016/j.ejim.2017.12.001. View

17.

Possick S, Khungar V, Deshpande R . Cardiac evaluation of the liver transplant candidate. Curr Opin Organ Transplant. 2023; 29(4):299-304. DOI: 10.1097/MOT.0000000000001122. View

18.

Roccaro G, Goldberg D, Hwang W, Judy R, Thomasson A, Kimmel S . Sustained Posttransplantation Diabetes Is Associated With Long-Term Major Cardiovascular Events Following Liver Transplantation. Am J Transplant. 2017; 18(1):207-215. PMC: 5740009. DOI: 10.1111/ajt.14401. View

19.

Koshy A, Farouque O, Cailes B, Ko J, Han H, Weinberg L . Prediction of Perioperative Cardiovascular Events in Liver Transplantation. Transplantation. 2020; 105(3):593-601. DOI: 10.1097/TP.0000000000003306. View

20.

Chen T, Chen G, Wang G, Treeprasertsuk S, Lesmana C, Lin H . Expert consensus on the diagnosis and treatment of end-stage liver disease complicated by infections. Hepatol Int. 2024; 18(3):817-832. DOI: 10.1007/s12072-023-10637-3. View