LIVER TRANSPLANTATION

LIVER TRANSPLANTATION is a topic covered in the Harrison's Manual of Medicine.

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Consider in the absence of contraindications for chronic, irreversible, progressive liver disease or fulminant hepatic failure when no alternative therapy is available (Table 157-4).

TABLE 157-4: Indications for Liver Transplantation
CHILDRENADULTS
Biliary atresiaPrimary biliary cirrhosis
Neonatal hepatitisSecondary biliary cirrhosis
Congenital hepatic fibrosisPrimary sclerosing cholangitis
Alagille’s syndromeaAutoimmune hepatitis
Byler’s diseasebCaroli’s diseasec
α1-Antitrypsin deficiencyCryptogenic cirrhosis
Inherited disorders of metabolismChronic hepatitis with cirrhosis
 Wilson’s diseaseHepatic vein thrombosis
 TyrosinemiaFulminant hepatitis
 Glycogen storage diseasesAlcoholic cirrhosis
 Lysosomal storage diseasesChronic viral hepatitis
 ProtoporphyriaPrimary hepatocellular malignancies
 Crigler-Najjar disease type IHepatic adenomas
 Familial hypercholesterolemiaNonalcoholic steatohepatitis
 Primary hyperoxaluria type IFamilial amyloid polyneuropathy
 Hemophilia 
aArteriohepatic dysplasia, with paucity of bile ducts, and congenital malformations, including pulmonary stenosis.
bIntrahepatic cholestasis, progressive liver failure, and mental and growth retardation.
cMultiple cystic dilatations of the intrahepatic biliary tree.

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Consider in the absence of contraindications for chronic, irreversible, progressive liver disease or fulminant hepatic failure when no alternative therapy is available (Table 157-4).

TABLE 157-4: Indications for Liver Transplantation
CHILDRENADULTS
Biliary atresiaPrimary biliary cirrhosis
Neonatal hepatitisSecondary biliary cirrhosis
Congenital hepatic fibrosisPrimary sclerosing cholangitis
Alagille’s syndromeaAutoimmune hepatitis
Byler’s diseasebCaroli’s diseasec
α1-Antitrypsin deficiencyCryptogenic cirrhosis
Inherited disorders of metabolismChronic hepatitis with cirrhosis
 Wilson’s diseaseHepatic vein thrombosis
 TyrosinemiaFulminant hepatitis
 Glycogen storage diseasesAlcoholic cirrhosis
 Lysosomal storage diseasesChronic viral hepatitis
 ProtoporphyriaPrimary hepatocellular malignancies
 Crigler-Najjar disease type IHepatic adenomas
 Familial hypercholesterolemiaNonalcoholic steatohepatitis
 Primary hyperoxaluria type IFamilial amyloid polyneuropathy
 Hemophilia 
aArteriohepatic dysplasia, with paucity of bile ducts, and congenital malformations, including pulmonary stenosis.
bIntrahepatic cholestasis, progressive liver failure, and mental and growth retardation.
cMultiple cystic dilatations of the intrahepatic biliary tree.

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