Practical Manual of Abdominal Organ Transplantation
Buku ini diterbitkan tahun 2002 oleh : Kluwer Academic Publishers, New York adalah buku edisi Pertama.
Judul: Practical Manual of Abdominal Organ Transplantation
Oleh: Cosme Manzarbeitia, M.D. (Editor)
Penerbit: Kluwer Academic Publishers, New York.
Tahun: 2002
Jumlah Halaman: 297 hal.
Editor:
Cosme Manzarbeitia, M.D.
Albert Einstein Medical Center
Philadelphia, Pennsylvania
Lingkup Pembahasan:
Buku ini adalah Panduan yang tidak hanya mencakup konsep dasar tetapi juga penjelasan topik kontroversial lainnya dan dalam rincian yang layak, meskipun secara ringkas. Perhatian yang ketat
untuk detail dan protokol, dasar klinis dan bedah suara, dan rasa yang kuat kerja sama tim akan terus melakukan perbaikan dalam pengajaran dan keberhasilan dalam pengelolaan pasien. Buku ini menggabungkan rinsip-prinsip yang diuraikan akan bermanfaat bagi pasien-pasien. Panduan ini
sistematis sesuai langkah pasien yaitu, pemeriksaan dan evaluasi, manajemen selama masa tunggu, proses Alokasi organ, prosedur bedah, awal dan akhir komplikasi, imunosupresi obat dan efek samping, serta hasil. Selain itu, teknik diagnostic yang digunakan dibahas secara khusus. Buku ini secara singkat seperti Pendekatan yang bermanfaat dalam menyediakan pembaca dengan pendekatan praktis untuk topik, dan jika perlu dianalisis lebih mendalam, membaca disarankan bias ditemukan pada akhir panduan ini. Tujuan dari buku ini adalah untuk membiasakan pengguna dengan tatacara terbaru dan isu-isu praktis yang timbul dalam pengelolaan sehari-hari penerima transplantasi organ perut, namun tidak terbatas pada, transplantasi hati, ginjal, dan pancreas. Untuk kajian mendalam dari setiap topik yang diberikan, jurnal dan buku teks terdaftar harus dikonsultasikan.
Daftar Isi:
I. PRETRANSPLANT EVALUATION AND MANAGEMENT
1. Indications for Liver Transplantation 3
Victor Araya, Javid Fazili, Vivek Kaul, Kenneth D. Rothstein, and Santiago J. Munoz
1.1. General Indications for Liver Transplantation 3
1.2. Disease-Specific Indications for Liver Transplantation 4
1.2.1. Acute Liver Failure 4
1.2.2. Primary Biliary Cirrhosis 4
1.2.3. Primary Sclerosing Cholangitis 5
1.2.4. Chronic Viral Hepatitis 5
1.2.5. Alcoholic Liver Disease 6
1.2.6. Hepatic Malignancy 6
1.3. Uncommon Indications for Liver Transplantation 7
1.4. Contraindications to Liver Transplantation 8
1.4.1. Absolute Contraindications 8
1.4.2. Relative Contraindications 9
2. Evaluation of Candidates for Liver Transplantation 11
Vivek Kaul, Kenneth D. Rothstein, Santiago J. Munoz, Jorge A. Ortiz, and Cosme Manzarbeitia
2.1. Organ Matching 11
2.2. Candidate Selection 12
2.2.1. Workup of Candidates 14
2.2.2. Waiting Lists and Waiting Period 17
2.3. Optimal Timing of Liver Transplantation 18
2.3.1. Fulminant Hepatic Failure 19
2.3.2. Chronic Liver Disease 21
2.3.3. Retransplantation: Whether or Not? 24
3. Management of the Patient Awaiting Liver Transplantation 27
Sammy Saab, Steven-Huy Han, and Paul Martin
3.1. Introduction 27
3.2. Ascites 27
3.2.1. Refractory Ascites 28
3.2.2. Spontaneous Bacterial Peritonitis (SBP): Treatment 29
3.2.3. Spontaneous Bacterial Peritonitis: Prophylaxis 30
3.2.4. Hepatorenal Syndrome 30
3.3. Encephalopathy 31
3.3.1. Treatment 31
3.3.2. Beenefits 32
3.4 Pruritus 33
3.5 Esophageal Varices 34
3.6 Malnutrition 37
3.7 Summary 39
4. Pretransplant Evaluation: Kidney and Pancreas 41
Jorge A. Ortiz, Cosme Manzarbeitia, and Radi Zaki
4.1. Evaluation of the Kidney Transplant Recipient 41
4.1.1 General Indications 41
4.1.2 Contraindications 41
4.1.3 Evaluation of Candidates 42
4.1.4 Waiting Lists and Waiting Period 44
4.2. Evaluation and Modalities of Pancreas Transplantation 44
4.2.1 Indications and Testing 44
4.2.2 Simultaneous Pancreas–Kidney Transplantation (SPK) 45
4.2.3 Pancreas after Kidney Transplantation (PAK) 46
4.2.4 Pancreas Transplant Alone (PTA) 46
4.3. Timing of Kidney and Pancreas Transplantation 46
5. Psychiatric and Social Workup of the Abdominal Organ Recipient 51
Kevin Hails
5.1. Psychological and Psychiatric Evaluation of the Transplant Recipient 51
5.1.1 Screening 51
5.1.2 Perioperative Period 56
5.1.3 Postoperative Period 56
5.2. Social Evaluation 57
5.2.1 Pretransplant Screening 58
5.2.2 Nontransplantation Candidates 59
5.2.3 Waiting Phase 59
5.2.4 Hospitalization Postsurgery 59
5.2.5 Discharge Planning 60
6. The Role of the Transplant Coordinator 61
Laurel Lerner and M. Catherine Morrison
6.1 Pretransplant Coordinator’s Role 63
6.2 Posttransplant Coordinator’s Role 64
II. ORGAN PROCUREMENT AND PRESERVATION
7. Organ Donation and the Allocation System 69
Cosme Manzarbeitia
7.1. Introduction 69
7.1.1 NOTA, OPTN, and UNOS 69
7.1.2 Death by Neurologic Criteria 70
7.2. Organ Procurement Organizations (OPOs) 70
7.2.1 Donor Evaluation and Management 70
7.2.2 Administrative Coordination of Multiorgan, Long-Distance Retrieval 71
7.3. Waiting Lists and Organ Allocation 71
7.3.1. Allocation of Kidneys and Pancreas 71
7.3.2. Allocation of Livers 72
8. Surgical Techniques for Liver Procurement 73
Sukru Emre and Cosme Manzarbeitia
8.1. Whole Liver Procurement 73
8.2. Reduced-Size and Split-Liver Transplantation 75
8.2.1. Split-Liver Procurement 76
8.2.2. Living Donor Liver Procurement 76
8.2.3. Complications and Ethical Concerns of Living Donor 78
9. Surgical Techniques for Kidney and Pancreas Procurement 81
Henkie P. Tan and Lloyd E. Ratner
9.1. Cadaveric Donor Nephrectomy 81
9.2. Living Donor Nephrectomy 4
9.2.1. Traditional Open Donor Nephrectomy 84
9.2.2. Laparoscopic Donor Nephrectomy 84
9.2.3. Complications and Ethics of Living Donor Kidney Procurement 89
9.3. Cadaveric Donor Pancreatectomy 90
9.3.1. Pancreas without Liver Procurement 90
9.3.2. Pancreas with Liver Procurement 91
9.4. Living Donor Pancreatectomy 92
III. RECIPIENT OPERATIVE TECHNIQUES AND STRATEGIES
10. The Liver Transplant Procedure 97
Cosme Manzarbeitia and Sukru Emre
10.1. Introduction 97
10.2. Whole Organ Implantation 98
10.2.1. Orthotopic Transplantation (OLT) 98
10.2.2. Piggyback Techniques 104
10.3. Heterotopic/Auxiliary Transplantation 105
10.4. Partial/Segmental Organ Implantation 106
10.4.1. Reduced-Size Liver Transplantation 106
10.4.2. Split-Liver Transplantation 106
10.4.3. Living Donor Liver Transplantation 109
10.4.4. Recipient Operation for Split-Liver and Living Donor Grafts 110
10.4.5. Special Considerations in Pediatric Liver Transplantation 112
11. The Kidney Transplant Procedure 115
Shuin-Lin Yang
11.1. Backtable Graft Preparation 115
11.2. Recipient Surgery 116
11.2.1. Position and Preparation 116
11.2.2. Incision at Lower Quadrant of Abdomen 116
11.2.3. Retroperitoneal Space Dissection 116
11.2.4. Isolation of Iliac Vessels 117
11.2.5. Vascular Anastomosis 117
11.2.6. Ureteric Reconstruction and Closure 118
12. The Pancreas Transplant Procedure 121
Jorge A. Ortiz
12.1. Backtable Preparation 121
12.2. Implantation Procedure 124
13. Anesthesia in Abdominal Organ Transplantation 125
Jonathan V. Roth and Jan Kramer
13.1. Anesthetic Management of the Organ Donor 125
13.2. Management of the Liver Transplant Recipient 126
13.2.1. Preoperative Evaluation 126
13.2.2. Perioperative Management 129
13.2.3. Intraoperative Management 131
13.3. Management of the Kidney Transplant Recipient 134
13.4. Management of the Pancreas Transplant Recipient 136
IV. IMMEDIATE POSTOPERATIVE CARE AND COMPLICATIONS
14. Postoperative Care in Liver Transplantation 141
Jorge A. Ortiz
14.1 General Intensive Care Issues 141
14.2 Renal Dysfunction 143
14.3 Neurologic Issues 144
14.4 Cardiovascular Issues 144
14.5 Hematologic Alterations 145
14.6 Infections in the Immediate Postoperative Period 146
14.7 Primary Graft Nonfunction (PNF) 147
14.8 Hemorrhagic Necrosis 148
14.9 Induction Immunosuppression 148
14.10 Hepatic Artery 148
14.11 Portal Vein 149
14.12 Inferior Vena Cava (IVC) and Hepatic Veins 150
14.13 Biliary System 150
14.14 Rejection 150
14.15 Intra-Abdominal Bleeding 151
15. Postoperative Care in Kidney Transplantation 153
Radi Zaki and Shuin-Lin Yang
15.1. Immunosuppression 153
15.2. Fluid Management 153
15.3. Hemodialysis 154
15.4. Hyper- and Hypotension 154
15.5. Hyperglycemia 154
15.6. Foley Catheter Management 155
15.7. Viral Prophylaxis 155
15.8. Surgical Complications 155
15.9. Complications Manifesting in Allograft Dysfunction 157
15.10. Vascular Complications 158
16. Postoperative Care in Pancreas Transplantation 161
Jorge A. Ortiz
16.1. General ICU Care 161
16.2. Immediate Complications of Pancreas Transplantation 162
16.2.1. Complications of Bladder Drainage 162
16.2.2. Vascular Complications 163
16.2.3. General Complications 164
17. Immunosuppression, Rejection Prophylaxis, and Other Pharmacotherapy of the
Transplant Recipient 167
Cosme Manzarbeitia, Michael K. McGuire, and Rohit Moghe
17.1. Introduction 167
17.2. Glucocorticoids 168
17.3. Calcineurin Inhibitors 169
17.3.1. Cyclosporine A (CyA) 169
17.3.2. Tacrolimus (Fk506,Prograf®) 170
17.4. Antimetabolites 171
17.4.1. Azathioprine (Imuran®) 171
17.4.2. Mycophenolate Mofetil (Cellcept®) 171
17.5. Antilymphocyte Antibody Preparations 172
17.5.1. Muromonab-CD3 (Orthoclone OKT3®) 172
17.5.2. Antithymocyte (Atg) Globulins 173
17.5.3. Interleukin 2 (IL-2) Receptor Antagonists 173
17.6. Sirolimus (Rapamune®) 174
17.7. Immunosuppressive Regimens 174
17.8. Other Medications 175
17.8.1. Antivirals 175
17.8.2. Antibacterials 178
17.8.3. Antifungals 179
17.8.4. Antihypertensives 179
17.8.5. Hypoglycemic Agents 180
17.8.6. Lipid-Lowering Agents 180
17.8.7. Supplements 180
V. LAST POSTOPERATIVE COMPLICATIONS AND OUTCOMES
18. General Late Complications in Transplantation 183
David J. Reich
18.1. Complications of Immunosuppression 183
18.1.1. Renal Dysfunction 183
18.1.2. Hypertension 184
18.1.3. Diabetes Mellitus 184
18.1.4. Hyperlipidemia 185
18.1.5. Obesity 185
18.1.6. Osteoporosis 185
18.1.7. Posttransplant Malignancies 186
18.1.8. Posttransplant Infections 186
18.2. Disease Recurrence, Chronic Rejection, and Technical Problems 187
18.2.1. Disease Recurrence 187
18.2.2. Chronic Rejection 187
18.2.3. Technical Problems 188
19.Organ-Specific Late Complications in Transplantation 189
David J. Reich, Cosme Manzarbeitia, Radi Zaki, Jorge A. Ortiz, and Sergio Alvarez
19.1. Liver Transplantation 189
19.1.1. Technical Complications 189
19.1.2. Chronic Hepatic Rejection 192
19.1.3. Recurrent Disease after Transplantation 192
19.2. Kidney Transplantation 194
19.2.1. Surgical Complications 194
19.2.2. Chronic Rejection 196
19.2.3. Disease Recurrence 196
19.3. Pancreas Transplantation 196
19.3.1. Rejection 196
19.3.2. Urologic Complications 197
19.3.3. Other Complications 198
20. Results of Abdominal Organ Transplantation 199
David J. Reich, Jorge A. Ortiz, and Cosme Manzarbeitia
20.1. Liver Transplantation 199
20.1.1. Overall Survival 199
20.1.2. Factors Affecting Survival 200
20.1.3. Quality of Life 202
20.1.4. Pregnancy after Liver Transplantation 202
20.2. Kidney Transplantation 202
20.3. Pancreas Transplantation 203
20.3.1. Graft Loss and Immunosuppression 204
20.3.2. Survival Rates and Results 204
VI. DIAGNOSTIC TOOLS IN ABDOMINAL TRANSPLANTATION
21. Pathology of Transplantation 209
Nayere Zaeri and Ierachmiel Daskal
21.1. Liver Transplant 209
21.2. Kidney Transplant 213
21.2.1. Organ Selection 214
21.2.2. Immune-Mediated Rejection 214
21.2.3. Scoring Rejection 218
21.2.4. Immunosuppressive Drug Toxicity 218
21.2.5. Posttransplantation Lymphoproliferative Disorders (PTLD) 219
21.2.6. Other Causes for Graft Loss 219
22. Radiology in Transplantation 221
Juan Oleaga
22.1. Pretransplant Evaluation 221
22.1.1. Liver 221
22.1.2. Kidney 223
22.2. Posttransplant Evaluation and Management 224
22.2.1. Liver 224
22.2.2. Kidney 227
22.2.3. Pancreas 229
23. Endoscopy in Liver Transplantation 231
Arthur J. Geller
23.1. Upper and Lower Gastrointestinal Endoscopy 231
23.2. Role of Endoscopic Retrograde Cholangiography (ERCP)in Liver Transplantation 232
23.2.1. Preoperative Evaluation and Treatment 232
23.2.2. Postoperative Biliary Complications 232
23.2.3. Management of Biliary Complications 233
Suggested Reading 239
Index 251
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