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.