Medical Surgical Nursing

 Capitalizing on the regenerative capacity of the liver cells, some surgeons have

successfully removed 90% of the liver.

 However, the presence of cirrhosis limits the ability of the liver to regenerate.

 Lobectomy

 Liver Transplantation

Liver Transplantation

 Liver disease for which no other form of treatment is available.

 The transplantation procedure involves total removal of the diseased liver and

its replacement with a healthy liver in the same anatomic location.

 The success of liver transplantation depends on successful immunosuppression

(i.e. cyclosporine corticosteroids).

Complications

 The postoperative complication rate is high, primarily because of technical

complications or infection.

 Immediate postoperative complication include bleeding, infection, and

rejection. Disruption, infection, or obstruction of the biliary anastomosis and

impaired biliary drainage may occur. Vascular thrombosis and stenosis are other

potential complications.

Nursing Management

1. Preoperative Nursing Interventions

 Provide the patient and family with full explanations about the procedure, the

chances of success, and the risks, including the side effects of long-term

immunosuppression. The need for close follow-up and lifelong compliance with

the therapeutic regimen.

 Malnutrition, massive ascites, and fluid and electrolyte disturbances are treated

before surgery to increase the chance of a successful outcome.

2. Post operative ;

 The patient is maintained in an environment as free from bacteria, viruses, and

fungi as possible to prevent infection.

 Cardiovascular, pulmonary, renal, neurologic, & metabolic functions are

monitored continuously.