9. Indications for Liver Transplantation in Adults and Children

  1. E. Jenny Heathcote MB, BS, MD, FRCP, FRCP(C)5,6,7,8
  1. Nazia Selzner MD, PhD1,2 and
  2. Vicky L. Ng MD, FRCPC3,4,6

Published Online: 4 SEP 2012

DOI: 10.1002/9781118314968.ch9

Hepatology: Diagnosis and Clinical Management

Hepatology: Diagnosis and Clinical Management

How to Cite

Selzner, N. and Ng, V. L. (2012) Indications for Liver Transplantation in Adults and Children, in Hepatology: Diagnosis and Clinical Management (ed E. J. Heathcote), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118314968.ch9

Editor Information

  1. 5

    Francis Family Chair in Hepatology Research, Toronto, Ontario, Canada

  2. 6

    University of Toronto, Toronto, Ontario, Canada

  3. 7

    Patient Based Clinical Research Division, Toronto Western Research Institute, Toronto, Ontario, Canada

  4. 8

    University Health Network/Toronto Western Hospital, Toronto, Ontario, Canada

Author Information

  1. 1

    Multi Organ Transplant Program, University of Toronto, Toronto, Ontario, Canada

  2. 2

    Division of Gastroenterology, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada

  3. 3

    Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada

  4. 4

    Liver Transplant Program, Sick Kids Transplant Center, The Hospital for Sick Children, Toronto, Ontario, Canada

  5. 6

    University of Toronto, Toronto, Ontario, Canada

Publication History

  1. Published Online: 4 SEP 2012
  2. Published Print: 12 OCT 2012

ISBN Information

Print ISBN: 9780470656174

Online ISBN: 9781118314968

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Keywords:

  • liver transplantation;
  • MELD;
  • PELD;
  • end-stage liver disease

Summary

Liver transplantation has revolutionized the management of acute fulminant and end-stage chronic liver diseases. Patients should be considered for liver transplantation if they have evidence of fulminant hepatic failure, a life-threatening systemic complication of liver disease or a liver-based metabolic defect, or, more commonly, cirrhosis with complications such as hepatic encephalopathy, ascites, hepatocellular carcinoma, hepatorenal syndrome, or bleeding caused by portal hypertension. The decision regarding the appropriateness of transplantation should usually be left to the transplant center because the contraindications for the procedure are mostly relative, often manageable, and change over time. Evaluation includes a detailed medical assessment to make sure that transplantation is technically feasible, medically appropriate, and in the best interest of both the patient and society.