The majority of the complications we are going to describe are linked to a graft malfunction. In the liver transplant a graft recovery defect has a multifactorial origin and can have clinical features that range from some transitory signs of functional deficit all the way to a fully-fledged primary non-function after orthotopic liver transplant (OLT). In such cases our treatment protocol provides for the use of prostaglandine in order to improve organ perfusion.Although the analysis of the efficacy of this pharmacological therapy is stil in progress, as it lies within the scope of our group’s experience we can state that in a certain number of cases it allows us to achieve a remission in the dysfunction symptoms. In the cases in which this treatment proves to be ineffective, there is a progressive deterioration in the hemocoagulative capacities, the protein synthesis, the neurological situation, the ventilatory exchange and the kidney function. The picture is completed by an increase in the enzymes of hepatic cytonecrosis, with an increase in the bilirubin, within a picture of hyperdynamic syndrome, characterised by an elevated cardiac index and a collapse in the vascular systemic resistances. In an overall dysfunction appears, during the wait for a new organ, one can turn to extracorporeal purification systems.

Metabolic complications in liver transplant

FAENZA, STEFANO;REPACI, SIMONE;SINISCALCHI, ANTONIO;
2007

Abstract

The majority of the complications we are going to describe are linked to a graft malfunction. In the liver transplant a graft recovery defect has a multifactorial origin and can have clinical features that range from some transitory signs of functional deficit all the way to a fully-fledged primary non-function after orthotopic liver transplant (OLT). In such cases our treatment protocol provides for the use of prostaglandine in order to improve organ perfusion.Although the analysis of the efficacy of this pharmacological therapy is stil in progress, as it lies within the scope of our group’s experience we can state that in a certain number of cases it allows us to achieve a remission in the dysfunction symptoms. In the cases in which this treatment proves to be ineffective, there is a progressive deterioration in the hemocoagulative capacities, the protein synthesis, the neurological situation, the ventilatory exchange and the kidney function. The picture is completed by an increase in the enzymes of hepatic cytonecrosis, with an increase in the bilirubin, within a picture of hyperdynamic syndrome, characterised by an elevated cardiac index and a collapse in the vascular systemic resistances. In an overall dysfunction appears, during the wait for a new organ, one can turn to extracorporeal purification systems.
Faenza S.; Repaci S.; Bernardi E.; Cimatti M.; Dante A.; Pierucci E.; Riganello I.; Siniscalchi A.; Spedicato S.; Zanoni A.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11585/49757
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