TY - CHAP M1 - Book, Section TI - Emergency Total Hepatectomy as a Bridge to Liver Transplantation A1 - Molmenti, Ernesto Pompeo A1 - de Santibañes, Martin A1 - McCann-Molmenti, Alexia A1 - Miyara, Santiago J. A1 - Molmenti, Hebe A1 - Sardo Molmenti, Christine L. A1 - Cagliani, Joaquin A1 - Sotiropoulos, Georgios C. A1 - Radtke, Arnold A1 - Sgourakis, Georgios A1 - César Bassan, Pablo A1 - Figari Bizzotto, Sabina A1 - Morales, Luis Fernando A1 - Nicastro, Jeffrey M. A1 - Coppa, Gene F. A1 - Rilo, Horacio A1 - de Santibañes, Eduardo A2 - Molmenti, Ernesto Pompeo A2 - Santibañes, Martin de A2 - Santibañes, Eduardo de Y1 - 2021 N1 - T2 - Liver Transplantation: Operative Techniques and Medical Management AB - Highly unstable individuals with liver failure who:Are candidates for liver transplantationHave no immediately available liver grafts for transplantationHave severe physiologic derangementsUnresponsive to therapyEntirely attributable to their liver failureCauses of liver failure:Fulminant hepatic failure associated with massive necrosisAcute graft failure associated with massive necrosisPrimary graft nonfunctionMassive trauma with exsanguinationSpontaneous hepatic ruptureMassive uncontrolled hemorrhageOther“Toxic liver syndrome”Total liver necrosisCardiovascular shockRenal failureLikely respiratory failureNeed for:Vasopressor supportRenal replacement therapyMechanical ventilationThe decision to proceed with emergency total hepatectomy as the first of a 2-stage transplant procedure should take into consideration:High mortality associated with:Current conditionAnhepatic stateWhether total hepatectomy will bring enough stability to justify transplantationExtent and reversibility of multiorgan failurePresence of sepsisNeurologic statusIntensive medical management is required to maintain some stability during the anhepatic phase.In instances where a liver graft becomes available, it should be determined that the recipient is stable enough to tolerate the implantation. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/04/20 UR - accesssurgery.mhmedical.com/content.aspx?aid=1180113042 ER -