肝臓ジャーナル: 病気と移植

Posttransplantation Care

After liver transplantation care must be taken because the complications don’t arise soon after the transplantation. They may arise after 2 or 3 weeks. Hence patients must be shifted to ICU and must be under observation. This is known as Post Transplantation care. Immediately following Orthotopic Liver Transplantation, these patients are returned to the surgical intensive care unit (ICU). In the ICU, they are maintained on a ventilator until fully conscious and able to breathe on their own while being able to protect their airway. During the ICU stay, there is a need for close attention to management of fluid and electrolytes, which could be significantly abnormal as a result of the prolonged operation and massive fluid shifts. Immunosuppressive agents, based on specific protocols and on the patient’s renal function, are started early after OLT. Doses are adjusted according to blood levels and functional status of the transplanted liver and renal function. Most patients with an uncomplicated postoperative course and good liver function remain in the ICU for 1 or 2 days before being transferred to an inpatient transplantation unit. Following transfer to a designated transplantation inpatient unit, the patient should be closely followed by the surgical and medical team, as well as by pharmacists, nutritionists, and physical therapists. Fluid and electrolyte status and kidney and liver function need to be monitored at least daily. Dosages of immunosuppressive agents are adjusted according to blood levels and organ function during this period.