Indications
for liver transplantation
1- Acute
liver failure
2- Cirrhosis
from chronic liver diseases
-
Chronic
hepatitis B virus and chronic
hepatitis C virus infection
-
Alcoholic
liver disease
-
Autoimmune
hepatitis
-
Cryptogenic
liver disease
-
Primary
biliary cirrhosis and primary
sclerosing cholangitis
-
Secondary
biliary cirrhosis
3- Metabolic
disorders
-
Alpha-1
antitrypsin deficiency
-
Hereditary
hemochromatosis
-
Wilson’s
disease
-
Glycogen-storage disorders
-
Type 1
hyperoxaluria
-
Familial
homozygous
hypercholesterolemia
4- Malignancy
5-
Miscellaneous
-
Polycystic
liver disease
-
Budd-Chiari
syndrome
Contraindications to liver
transplantation
1- Absolute
contraindications
-
Brain death
-
Extrahepatic malignancy
-
Active
uncontrolled infection
-
Active
alcoholism and substance abuse
-
AIDS
-
Severe
cardiopulmonary disease
-
Uncontrolled sepsis
-
Inability
to comply with medical regimen
-
Lack of
psychosocial support
-
Anatomic
abnormalities precluding liver
transplantation
-
Compensated
cirrhosis without
complications (Child-Turcotte-Pugh
score, 5–6)
2- Relative
contraindications
-
Advanced
age
-
Cholangiocarcinomaa
-
HIV
infectiona
-
Portal vein
thrombosis
-
Psychologic
instability
a Transplantation
for cholangiocarcinoma is
undergoing study using protocols
with strict selection criteria
and use of chemotherapy and
radiation. Transplantation for
HIV infection without AIDS also
is undergoing study as part of a
National Institutes of Health
protocol
References:
-
Yu
AS, Keeffe EB. Liver
transplantation. In:
Zakim D, Boyer TD,
editors. Hepatology: a
textbook of liver
disease. 4th edition.
Philadelphia:
Elsevier; 2003. p.
1617–56.
-
Ahmed A, Keeffe EB.
Current indications
and contraindications
for liver
transplantation. Clin
Liver Dis. 2007
May;11(2):227-47.
[Medline]