Designation
Consultant Hepatology and Gastroenterology
Institution
Hospital Selayang
Qualification
MB BCh BAO (NUI), MRCP (UK)
Special field of interest
Transplant hepatology, general hepatology
Abstract
Title: |
ALF When Is It Futile for Transplant? |
Body: |
ALF is characterised by a deterioration in liver function tests, and potentially associated with dysfunction in other organs. The use of liver transplant has been the most significant development in the treatment of ALF in 40 years and it has improved survival. The most difficult - and perhaps, most important - decision that a clinician makes for a patient who needs liver transplant is when not to proceed with liver transplant. While an individual may be suitable for transplant surgery at listing, he may become too sick while waiting. There is however little consensus on when not to proceed with liver transplant, and as a result, the threshold for "too sick for transplant" varies according to provider and program. Looking at the characteristics of patients who develop adverse outcomes after transplant can help facilitate the decision regarding whether a patient is "too sick for transplant". |
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