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Autoimmune Hepatitis and Primary Sclerosing Cholangitis- not common to have both, usually overlap type syndrome that pathology is not able to clearly differentiate. This makes treatments difficult.
- Patients are placed on the transplant list when they begin losing synthetic liver function
- PSC patients can get priority on the list because they have high mortality even if synthetic function is intact (they are prone to cholangitis)
Posted 11/28/16 11:00:32 AM by Adam Faye
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MELD Score - Initially used to predict 90-day mortality post-TIPS (Transjugular intrahepatic Portosystemtic Shunt)
MELD-Na - MELD scores now incorporate Na- shown to be an independent predictor of mortality.
Posted 11/28/16 11:16:19 AM by Adam Faye
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Post-Liver Tx
- MELD >40, post-transplant have worse outcomes
- Pancytopenia in Liver disease- often from Hypersplenism
- Post-op intra-abdominal hematoma more likely in patients with portal HTN (higher bleed risk)
- PSC can recur post-transplant (~20%)
- AIH does not recur after transplant but has increased rejection risk
- Liver transplation confers low risk for rejection - interestingly, combined liver/kidney transplant has lower rejection risk than kidney alone
Posted 11/28/16 11:26:07 AM by Adam Faye
Created by Christopher Kelly
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