Resident Curriculum Unit 4: Liver Transplantation
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Unit Objectives
I. Outline the basic principles of liver transplantation, donor and recipient selection and donor allocation.
II. Describe the types of immunosuppressive therapy utilized in liver transplantation.
III. List the different disease processes which may require liver transplantation; understand the management of complications of liver disease including end stage liver disease and the care of patients with fulminant hepatic failure.
IV. Describe the workup needed to diagnose liver transplant rejection.
V. Describe the operative steps necessary involved in performing liver allograft recovery from deceased donors and deceased donor liver transplant.
VI. Diagnose and implement treatment approaches for both short and long term medical and surgical complications following liver transplantation
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Contains 5 Component(s), Includes Credits
John P. Roberts, MD
Author: John P. Roberts, MD
1. Appreciate the overall benefit of live donor liver transplantation (LDLT) as compared to deceased donor transplantation and waiting list risk
2. Understand factors associated with improved LDLT outcomes
3. Profile of complications is LDLT setting versus deceased donor liver transplants
4. Unique complications and concerns with living donor liver transplantation: Small for size, HCV, HCC
5. Financial implications of LDLT
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Contains 5 Component(s), Includes Credits
Elizabeth Pomfret, MD, PhD and Megan Adams, MD
1. How should consent be approached with regard to liver transplantation and organs with special considerations?
2. Understand donor specific concerns with regard to management and outcomes
3. Understand what resources are available to assist with organ evaluation and decision making
Authors: Elizabeth Pomfret, MD, PhD/Megan Adams, MD
Megan Adams, MD
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Contains 5 Component(s), Includes Credits
Mohamed Akoad, MD, FACS
Author: Mohamed Akoad, MD, FACS
1) Describe indications for liver biopsy
2) Describe the advantages/disadvantages of blind versus image-guided liver biopsy
3) Describe the potential locations for percutaneous liver biopsy
4) Describe the steps and post-procedure monitoring for percutaneous liver biopsy
5) Describe potential complications of liver biopsy
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Contains 5 Component(s), Includes Credits
David A. Axelrod, MD, MBA
Author: David A. Axelrod, MD
1. Describe minimally invasive treatment options and indications for transarterial chemoembolization (TACE), radiofrequency ablation (RFA), trans arterial radioembolization (TARE), and stereotactic radiation.
2. Describe patients who may be candidates for resection of HCC based on anatomy and underlying liver reserve
3. Describe the Milan and UCSF criteria used for transplant candidacy and the role of downstaging
4. Describe the MELD exception process for transplant candidates with HCC
5. Discuss adjuvant therapies for HCC
6. Understand the BCLC treatment algorithm
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Contains 5 Component(s), Includes Credits
David A. Axelrod, MD, MBA and Abhinav Seth, MBBS
Author: David A. Axelrod, MD and Abhinav Seth, MBBS
- Understand the evolving epidemiology of HCC in the US
- Understand which populations should be screened for HCC and which studies should be used
- Understand diagnostic criteria for HCC
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Contains 5 Component(s), Includes Credits
Jonathan Fryer, MD
Author: Jonathan Fryer, MD
Learning Objectives:
1. Define and review the potential causes of Budd-Chiari Syndrome
2. Understand the diagnostic pathway for Budd-Chiari Syndrome
3. Discuss the management of Budd-Chiari Syndrome
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Contains 5 Component(s), Includes Credits
Cary Caldwell, MD
Author: Cary Caldwell, MD
1. Describe the incidence, mechanisms and manifestations of Alcoholic Liver Disease
2. Describe the selection process for ESLD patients with ALD
3. Describe the stratagems of Transplant Centers in dealing with ALD patients
4. Describe the results of OLT in ALD patients
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Contains 5 Component(s), Includes Credits
John P. Roberts, MD
Author: John P. Roberts, MD
1. Appreciate the overall benefit of live donor liver transplantation (LDLT) as compared to deceased donor transplantation and waiting list risk
2. Understand factors associated with improved LDLT outcomes
3. Profile of complications is LDLT setting versus deceased donor liver transplants
4. Unique complications and concerns with living donor liver transplantation: Small for size, HCV, HCC
5. Financial implications of LDLT -
Contains 5 Component(s), Includes Credits
Elizabeth Pomfret, MD, PhD and Megan Adams, MD
1. How should consent be approached with regard to liver transplantation and organs with special considerations?
2. Understand donor specific concerns with regard to management and outcomes
3. Understand what resources are available to assist with organ evaluation and decision makingAuthors: Elizabeth Pomfret, MD, PhD/Megan Adams, MD
Megan Adams, MD
-
Contains 5 Component(s), Includes Credits
Mohamed Akoad, MD, FACS
Author: Mohamed Akoad, MD, FACS
1) Describe indications for liver biopsy
2) Describe the advantages/disadvantages of blind versus image-guided liver biopsy
3) Describe the potential locations for percutaneous liver biopsy
4) Describe the steps and post-procedure monitoring for percutaneous liver biopsy
5) Describe potential complications of liver biopsy -
Contains 5 Component(s), Includes Credits
David A. Axelrod, MD, MBA
Author: David A. Axelrod, MD
1. Describe minimally invasive treatment options and indications for transarterial chemoembolization (TACE), radiofrequency ablation (RFA), trans arterial radioembolization (TARE), and stereotactic radiation.
2. Describe patients who may be candidates for resection of HCC based on anatomy and underlying liver reserve
3. Describe the Milan and UCSF criteria used for transplant candidacy and the role of downstaging
4. Describe the MELD exception process for transplant candidates with HCC
5. Discuss adjuvant therapies for HCC
6. Understand the BCLC treatment algorithm -
Contains 5 Component(s), Includes Credits
David A. Axelrod, MD, MBA and Abhinav Seth, MBBS
Author: David A. Axelrod, MD and Abhinav Seth, MBBS
- Understand the evolving epidemiology of HCC in the US
- Understand which populations should be screened for HCC and which studies should be used
- Understand diagnostic criteria for HCC
-
Contains 5 Component(s), Includes Credits
Jonathan Fryer, MD
Author: Jonathan Fryer, MD
Learning Objectives:
1. Define and review the potential causes of Budd-Chiari Syndrome
2. Understand the diagnostic pathway for Budd-Chiari Syndrome
3. Discuss the management of Budd-Chiari Syndrome -
Contains 5 Component(s), Includes Credits
Cary Caldwell, MD
Author: Cary Caldwell, MD
1. Describe the incidence, mechanisms and manifestations of Alcoholic Liver Disease
2. Describe the selection process for ESLD patients with ALD
3. Describe the stratagems of Transplant Centers in dealing with ALD patients
4. Describe the results of OLT in ALD patients