A Narrative Review of the Evaluation and Management of Liver Transplant Complications in the Emergency Department

• Published in: The Journal of emergency medicine Vol. 64; no. 5; pp. 596 - 609
• Main Authors: Sibai, Rayan El, Freedman, Sari R., Gatz, J. David
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2023
• Subjects: emergency medicine; Emergency Service, Hospital; Humans; Liver; liver transplantation; Liver Transplantation - adverse effects; opportunistic infection; postoperative complication; Postoperative Complications - diagnosis; Postoperative Complications - etiology; Postoperative Complications - therapy; postoperative complication; opportunistic infection; emergency medicine; liver transplantation
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2023.02.022

Liver transplant recipients are prone to both short-term and long-term complications and may present to any emergency department. This narrative review summarized key aspects of liver transplantation and reviewed the major complications that may result in emergency department presentation. Liver transplantation is the only curative therapy for end-stage liver disease and the liver is the second most commonly transplanted solid organ. With nearly 100,000 living liver transplant recipients in the United States, these patients no longer present exclusively to transplantation centers. Critical complications may manifest with a variety of subtle signs and symptoms that must be considered by the emergency physician. Appropriate evaluation often includes laboratory analysis and imaging. Treatment may be time-sensitive and is variable depending on the specific complication. Emergency physicians in all settings must be prepared to evaluate and treat liver transplant recipients who present with potential graft- and life-threatening complications.