Postoperative Care of the Liver Transplant Recipient

Liver transplantation for both acute and chronic liver failure results in excellent outcomes. Perhaps more than with any other surgical program, graft and patient outcomes for liver transplantation reflect the combined efforts of several specialties. The success stems from a multidisciplinary approach with close involvement of gastroenterologists, anesthesiologists, surgeons, and intensivists. This chapter will review topics related to the immediate care of the liver transplant patient in the intensive care unit (ICU). Existing evidence on hemodynamic monitoring, respiratory failure, neurologic management, electrolyte and glucose correction, coagulation management, systemic immunosuppression, graft function and rejection, and technical problems will be reviewed. The chapter will conclude with brief mention of long-term complications related to recurrence of disease that may lead to future ICU admissions.