Transplant critical care: Standards for intensive care of the patient with liver failure before and after transplantation

✍ Scribed by Claus U. Niemann; David J. Kramer

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 60 KB
• Volume: 17
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.22289

✦ Synopsis

Patients with impending or established single or multiple organ system failure are described as critically ill. Patient outcomes are optimized by skilled nursing units led by physicians trained in critical care medicineintensivists. The impetus for subspecialization in the practice of critical care is the identification of groups of critically ill patients who require specialized knowledge, experience, and monitoring techniques that are outside the mainstream of critical care medicine. Well-recognized areas of expertise include neonatology, pediatrics, cardiology/cardiac surgery, and neurology/neurosurgery. In each area, intensive care is provided by physicians or surgeons who have subspecialty knowledge and skills as well as critical care training.

Similarly, critically ill solid organ transplant candidates and recipients benefit from specialized transplant critical care. These specialists are versed in the care of patients with end-stage organ failure, attendant critical illnesses, and in the perioperative management of these patients at the time of transplantation. Preoperatively, transplant critical care intensivists attempt to optimize a transplant candidate with a specific type of end-organ failure so that the patient remains eligible for transplantation. Postoperatively, the targets of critical care are both the posttransplant patient and the newly implanted allograft. Essentially, postoperative care has to be provided to 2 different biological systems that require individual attention and