Demographics And Survival

Worldwide, approximately 7000 liver transplantations are performed yearly. In the United States, more than 4000 liver transplantations are performed at more than 100 centers each year. At present, the number of transplantations performed is limited only by the availability of organ donors. Before the 1980s, 1-year survival after liver transplantation was approximately 30 percent. Improvements in surgical techniques, immunosuppression protocols, and patient selection have increased mean patient survival to 87 percent at 1 year and 77.4 percent at 3 years.1 Transplantation is the treatment of choice for end-stage liver disease (ESLD) refractory to all other interventions and is considered an effective means to improve quality of life as well as survival. 2 As this population of patients continues to grow, so will the number of patients with liver transplantation who present to the emergency department (ED) with transplant- and non-transplant-related problems. The incidence of transplant-related problems is high (Ta.bIe,,86-1) and evaluation is made difficult by the fact that many of the complications present with similar signs, symptoms, and laboratory abnormalities. Most transplant-related problems will require, at a minimum, direct communication with the transplant center for consultation and follow-up.

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TABLE 86-1 Common Complications Following Liver Transplantation

TABLE 86-1 Common Complications Following Liver Transplantation

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