Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

01 April 2004

Adjuvant drugs for end-stage liver failure and transplantation

Youri Vater, Adam Levy, Kenneth Martay, Clare Hunter, Avi A. Weinbroum

Med Sci Monit 2004; 10(4): RA77-88 :: ID: 11639

Abstract

End-stage liver failure is currently treatable both by dialysis and by liver transplantation, but this does not detract from its being a complex pathophysiological and pharmacological entity. More patients survive after transplant because of the impressive developments that enabled improved liver preservation, anesthesia and surgical techniques, as well as immunosuppressive drug therapy. Because of its multifaceted metabolism, liver failure can nevertheless cause a complex of pathophysiological conditions and, as such, poses a challenge for surgeons and anesthesiologists alike, not only before surgery but during transplantation as well. Obviating these problems frequently requires the use of adjunct drugs before, during and after liver transplantation, and these medications must be carefully balanced with each other while being alert to the avoidance of negative side effects. Hepatorenal syndrome and massive bleeding are the two main grave phenomena that characterize these patients before and during liver transplant, and this article will provide an overview of the adjunct drugs that are used to circumvent them perioperatively. Specifically, it details the drugs that are used to preserve and improve the already precarious hemodynamic conditions (e.g, by vasopressors, vasodilators, and beta blockers), as well as diuretics and hepato-protective drugs (e.g, furosemide, mannitol), antifibrinolytics (including the new recombinant activated Factor VII) and immunosuppressive drugs. Their doses and the ongoing debate on their concomitant use are reported as well.

Keywords: Adjuvants, Immunologic - pharmacology, Antifibrinolytic Agents - pharmacology, Cardiovascular Agents - pharmacology, Diuretics - pharmacology, Hepatorenal Syndrome - drug therapy, Hepatorenal Syndrome - etiology, Immunosuppressive Agents - pharmacology, Liver Failure - complications, Liver Failure - surgery, Liver Transplantation - immunology, Adjuvants, Immunologic - pharmacology, Antifibrinolytic Agents - pharmacology, Cardiovascular Agents - pharmacology, Diuretics - pharmacology, Hepatorenal Syndrome - etiology, Immunosuppressive Agents - pharmacology, Liver Failure - surgery, Liver Transplantation - immunology

Add Comment 0 Comments

Editorial

01 February 2024 : Editorial  

Editorial: Global Health Concerns as Vaccine-Preventable Infections Including SARS-CoV-2 (JN.1), Influenza, Respiratory Syncytial Virus (RSV), and Measles Continue to Rise

Dinah V. Parums

DOI: 10.12659/MSM.943911

Med Sci Monit 2024; 30:e943911

0:00

In Press

08 Feb 2024 : Clinical Research  

Predictors of Mortality in Veterans with Amyotrophic Lateral Sclerosis: Respiratory Status and Speech Disor...

Med Sci Monit In Press; DOI: 10.12659/MSM.943288  

0:00

25 Feb 2024 : Clinical Research  

Patterns and Outcomes of Traumatic Suicides: A Retrospective Study of 132 Patients Admitted to a Turkish Me...

Med Sci Monit In Press; DOI: 10.12659/MSM.943505  

0:00

01 Feb 2024 : Review article  

Review of the Evaluation of Pulmonary Hypoplasia as an Important Determinant of Clinical Outcomes in Infant...

Med Sci Monit In Press; DOI: 10.12659/MSM.943259  

0:00

19 Feb 2024 : Clinical Research  

Diagnostic Accuracy of Ileocolic Artery and Vein Diameter for Acute Appendicitis

Med Sci Monit In Press; DOI: 10.12659/MSM.943846  

Most Viewed Current Articles

16 May 2023 : Clinical Research  

Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...

DOI :10.12659/MSM.940387

Med Sci Monit 2023; 29:e940387

0:00

17 Jan 2024 : Review article  

Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron Variant

DOI :10.12659/MSM.942799

Med Sci Monit 2024; 30:e942799

0:00

14 Dec 2022 : Clinical Research  

Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase Levels

DOI :10.12659/MSM.937990

Med Sci Monit 2022; 28:e937990

0:00

01 Jan 2022 : Editorial  

Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...

DOI :10.12659/MSM.935952

Med Sci Monit 2022; 28:e935952

0:00

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750