• 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

• 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

• 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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