Pre- Transplant Management
This is the most common PICU indication for urgent liver transplant
What is Acute Liver Failure
These are the post-op admission priority assessments
What are Hemodynamics and Hepatic US (stat preferred).
What is maintenance immunosuppression
This is the most common vascular complication post transplant and cause for early graft loss
What is Hepatic Artery Thrombosis
These physical signs could suggest rejection
What is fever, jaundice, hepatomegaly, malaise
This acid-base imbalance is common is acute liver failure?
What is metabolic acidosis
This is indicated with a sudden increase in abdominal girth.
What is Bleeding, ascites, graft swelling.
This antifungal is often given orally
What is nystatin
This lab result is often the first sign of graft dysfunction
What are rising AST/ALT
This is the treatment plan for acute rejection.
What is high-dose steroids and adjusting immunosuppression
This is why patients are at a higher risk for infection before transplant
What is immune disfunction along with invasive devices?
This pain control method is often avoided.
This medication is used as induction immunosuppression or in steroid resistant rejection.
These medications are associated with a rising creatinine and low urine output, indicating nephrotoxicity
What are tacrolimus and cyclosporine
This form of rejection is rare, but can be severe.
What is hyperacute rejection.
This is why bleeding is a major concern.
What is coagulopathy from impaired clotting factor production?
What is semi fowlers
This drug causes tremors, hypertension, and neurotoxicity
What is Tacrolimus
This complication is suspected when INR continues to rise after giving Vitamin K
What is liver dysfunction
A biopsy can help distinguish these two complications after transplant
What is infection vs biliary obstruction?
This is a major sign of worsening encephalopathy
What is altered mental status, seizures, asterixis
These labs should be trended frequently in the post op period.
What are LFTs, bilirubin, INR, creatnine, tacrolimus levels.
This drug is used to prevent pneumocystis pneumonia.
Bactrim (TMP- Sulfamethoxazole)
When bleeding post op, these are the signs and symptoms that the nurse may see.
What is ascites and hypotension
This finding indicates graft ischemia rather than rejection.
What is sudden abdominal pain with absent doppler flow