TY - JOUR
T1 - Perioperative Management of the Patient with End-Stage Liver Disease
AU - Simmons, Flora
AU - Roberson, Tailour
AU - Owolabi, Adebukola
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.
PY - 2024
Y1 - 2024
N2 - Purpose of Review: End-stage liver disease is associated with increased perioperative morbidity and mortality. This narrative review provides a summary of perioperative concerns and management of patients with end-stage liver disease. Recent Findings: Model for end-stage liver disease (MELD) 3.0 is the most updated version of the MELD score which is used as both a prognostic score to prioritize organ allocation and to assess the severity of liver disease. The American Association for the Study of Liver Disease and The American Gastroenterological Association have provided updated guidelines on procedural bleeding and transfusion management in patients with liver disease. There is controversy on the issue of prophylactic transfusion for target thresholds prior to surgery. Summary: Preoperative risk assessment is dependent on the severity of liver disease, type of surgery, urgency of surgery, age, and comorbidities. Patients with end-stage liver disease may need higher acuity of care in the postoperative period.
AB - Purpose of Review: End-stage liver disease is associated with increased perioperative morbidity and mortality. This narrative review provides a summary of perioperative concerns and management of patients with end-stage liver disease. Recent Findings: Model for end-stage liver disease (MELD) 3.0 is the most updated version of the MELD score which is used as both a prognostic score to prioritize organ allocation and to assess the severity of liver disease. The American Association for the Study of Liver Disease and The American Gastroenterological Association have provided updated guidelines on procedural bleeding and transfusion management in patients with liver disease. There is controversy on the issue of prophylactic transfusion for target thresholds prior to surgery. Summary: Preoperative risk assessment is dependent on the severity of liver disease, type of surgery, urgency of surgery, age, and comorbidities. Patients with end-stage liver disease may need higher acuity of care in the postoperative period.
KW - Child-Turcotte-Pugh score
KW - Liver disease and non-hepatic surgery
KW - MELD
KW - Optimization of liver disease
KW - Perioperative management for liver disease
KW - Surgical risk calculators for liver disease
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U2 - 10.1007/s40140-024-00618-z
DO - 10.1007/s40140-024-00618-z
M3 - Article
AN - SCOPUS:85184454017
SN - 2167-6275
JO - Current Anesthesiology Reports
JF - Current Anesthesiology Reports
ER -