Journal of Perioperative & Critical Intensive Care Nursing
Open Access

Recommendations and Preoperative Care for Patients Having Liver Surgery

Tarika Singh^{* *}Correspondence: Tarika Singh, Department of Nursing, King George Medical University, Uttar Pradesh, India, Email:

Author info »

Description

Liver transplantation is one of the therapies for many liver diseases that are considered as fatal. Because of developments in liver transplant surgery, anesthesia, and postoperative care, an increasing number of liver transplant procedures are now feasible. The objective of this study is to examine some of the important key advancements in preoperative assessment, intraoperative monitoring, and postoperative monitoring for liver transplant patients. Liver transplantation is still an option for treating many of the fatal liver diseases.

The first liver transplant on a person was performed in Denver, Colorado, in 1963. In India, 350 liver transplants were performed between 1995 and 2011. The number of operations performed and the success rate have been increased as a result of numerous perioperative management advancements, including expertise in surgical techniques, improved pre-operative optimization, intraoperative monitoring and management, changes in immunosuppression regime, and improvements in post-operative management. One-year survival following a liver transplant has risen from 72% to 79% in 1998 to 85% - 90% in 2008. Ten-year survival increased from 33% in 1998 to 53% in 2008 and 66% in 2010, a rise from 33%.

Preoperative assessment for liver transplantation

Prognostic indices for a 1-year survival without liver transplantation, such as Child-Turcotte-Pugh or Revised Model for End-Stage Liver Disease (MELD) scores, are used to determine the necessity of liver transplantation in patients with chronic liver disease. The patient's comorbidities, both those related to and separate from liver failure, are thoroughly examined to determine the perioperative risks. Pre-transplant infections illness screening is required for both donors and recipients to prevent post-operative infectious problems (dental, ophthalmic, otorhinolaryngological, and urogenital). In order to determine the unfavorable variables impacting the result and design countermeasures, a psychological examination of the transplant patient is helpful.

India has a limited number of liver transplantation centers, yet they are continually growing. Similar to the United Network for Organ Sharing database in the United States, the Indian Society of Organ Transplantation has established an electronic central database of organ transplants (including liver transplants) in order to gather data, assist in long-term follow-up, and conduct research studies that can enhance patient care in the future.

The management of liver transplants may be taught using simulation and a porcine model. The most recent research was used to create and the Delphi method was used to ratify the present Enhanced Recovery After Surgery (ERAS) rules. Nevertheless, to support the therapeutic usage of the recommended regimen, prospective trials are required. Organ transplantation is beneficial for many people with end-stage liver disease because it raises survival rates and enhances quality of life. Significant improvements in intraoperative methods and administration, as well as improved organ collection and preservation, have all been made in this field. A further important factor in boosting transplant recipient survival is the greater standard of care provided in critical care units. The field of liver transplantation has advanced throughout time in terms of preoperative planning, perioperative observation and care, organ perfusion, and rapid tracking. Research is required in the areas of hemodynamic monitoring, blood and coagulation management, and quick tracking to confirm the effectiveness of one method over another.