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Chapter 21 - Recipient selection

from Section 4 - Liver

Published online by Cambridge University Press:  07 September 2011

By
Alex Gimson
Edited by
Andrew A. Klein ,
Clive J. Lewis  and
Joren C. Madsen
Andrew A. Klein
Affiliation:
Papworth Hospital NHS Trust
Clive J. Lewis
Affiliation:
Papworth Hospital NHS Trust
Joren C. Madsen
Affiliation:
Massachusetts General Hospital
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Summary

A stringent process of selection of appropriate candidates for liver transplantation is necessary for a number of reasons. This chapter discusses deceased organ transplantation in adults. In liver transplant practice, a distinction needs to be made between the process of selection of appropriate candidates for transplant, which is the main focus of the chapter, and that of organ allocation for those candidates who have been placed on the waiting list for the procedure. Both of these processes are underpinned by similar considerations with respect to the relevant clinical end points and ethical standpoints. The practice of candidate selection and organ allocation is predicated on two fundamental ethical principles: justice (or equity) and utility. Most liver transplant programs have adopted the Milan criteria for selecting patients with hepatocellular carcinoma (HCC) for transplantation. Rarely, patients with heart and liver failure will be considered for combined heart-liver or heart-lung-liver transplant.

Keywords

chronic renal failurecoronary artery vasculopathydiabetes mellitushyperlipidemiahypertensionheart transplantationgraft failureimmunosuppressionmetabolic syndrome risk factorsrenal dysfunction
Type
Chapter
Information
Organ Transplantation
A Clinical Guide
 , pp. 173 - 181
Publisher: Cambridge University Press
Print publication year: 2011

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