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The management of chronic liver disease, including transplantation 1
Published on September 30, 2021 29 min
A selection of talks on Clinical Practice
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- Dr. Gina Touch Mercer
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The history and foundations of medical research ethics
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Hello, my name is Tim McCashland, I'm Professor of Medicine, and Director of Liver Transplant and Hepatology, at the University of Nebraska Medical Center. Today I would like to talk about the management of other aspects of chronic liver disease, including liver transplantation.
The outline for today's talk includes: management of common complications associated with end-stage liver disease; preparation for evaluation and listing for liver transplantation; listing criteria for liver transplantation; management of common medical conditions after transplantation. First, we'll start with management of common complications associated with end-stage liver disease.
The number one complication of end-stage liver disease is ascites. There is a 50% 10-year probability of accumulation of ascites in somebody with end-stage liver disease. It's a harbinger of poor prognosis, with 50% mortality within two years of diagnosis, for patients who have a large amount of ascites. Ascites can be graded from grade 1 to 3, based upon the volume of the ascites, with ultrasound diagnosis for grade 1, grade 2 with moderate abdominal distention, and grade 3 with tense ascites and significant abdominal discomfort. Typically speaking, you require at least 1,500 ml of ascites to be detected by physical examination. Ascites typically is associated with a clear yellow consistency in color. If the ascites - on tapping - is bloody in appearance, the hematocrit should be greater than 0.5 percent.