Liver Transplant Team
Liver Transplant – A Multidisciplinary team Approach
The following is a description of liver transplant team members who will care for you before, during and after the transplant.Hepatologist (Liver Transplant Physician)
Just as before surgery, the hepatologist continues managing patients’ medical care following transplantation. The hepatologist and surgeon guide the transplant team through the recovery and monitor any possible rejection or infection of the new liver. To help prevent rejection, the hepatologist and surgeon will determine what immunosuppressive medications are needed. The hepatologist and surgeon will also oversee the post-transplant follow-up care.
The transplant surgeons assess the patient before surgery, perform the liver transplant and help guide the patient through recovery.
The surgeon, along with the hepatologist and ICU team, monitors the patients vital signs and the function of the transplanted liver to ensure it is working properly. Additionally, they decide what medications you’ll take and observe the wound to see that it is healing as necessary.
The anesthesiologist administers a general anesthetic prior to the liver transplant surgery and monitors the heart and lung function throughout the operation.
Operating room staff
The Operating room has specially trained highly skilled personnel such as dedicated nurses, technical support staff , pharmacists and paramedical workers who take care of all the requirements of complex operations such as transplantation.
Diagnostic and interventional radiologist
Radiologists are doctors who are experts in interpreting X-rays, ultrasound, CT scan and MRI scans and thus help with ascertaining the diagnosis. Interventional radiologists perform interventions such as biopsies, embolisation and stenting of bile ducts and blood vessels using ultrasound or CT scan to guide the procedure. Some of these techniques are extremely useful to treat certain complications that may occure after liver transplantation. Interventional radiologists also treat liver cancers by using techniques such as radiofrequency ablation, microwave ablation, transarterial chemoembolization and radioembolization.
Hospitalist/ Physician Assistant
The physician assistant is a healthcare professional who assists the physician with patient care. The hospitalist provides day-to-day management of patients in the hospital, both before and after liver transplantation and works closely with the transplant surgeon and hepatologist to deliver care.
Infectious disease specialists
After transplantation, patients are on medications to suppress their immune system and are therefore vulnerable to a number of infections. Some of these infections can be complex and difficult to diagnose and treat. Thus it is extremely important to have doctors specialized in the care and the management of infections after transplantation. They manage the patients both before transplant by suggesting correct vaccines and antibiotics as well as after after transplantation.
The transplant coordinators are in charge of coordinating all aspects of the transplant process, including the pre-transplant evaluation, transplant hospitalization and post-transplant follow-up. Their many responsibilities include patient and family education throughout the entire transplant process and ongoing communication. The transplant coordinators are also involved in the organ procurement and retrieval process, as well as community and professional education. They are an integral part of the transplant team and work very closely with all of the physicians including the referring doctor, the transplant surgeons and the hepatologists.
The hospital’s staff nurses are responsible for coordinating the efforts of all the caregivers. Nurses spend the greatest amount of time with the patient, they are in the unique position to evaluate the well-being, meet the immediate needs and act as a link among the various team members. They are available to provide a range of services, interventions and expertise, and to represent the best interest. The nursing staff is committed to keeping the patient well-informed about every aspect of the health care needs and emphasizes patient education. They offer instruction and information both formally and informally, and try to include the family or caregiver(s) in the learning process.
The liver transplant social worker is part of the Liver Transplant Team and involved with you from the time of the initial evaluation. The social worker provides the team with a psychosocial assessment that includes a social history and assessment of the patient’s and family’s coping abilities, motivation, compliance and support system. Practical issues such as who will stay with the patient after discharge from the hospital are assessed. When necessary, the social worker can offer suggestions about how to initiate fundraising.
The social worker provides counseling and emotional support to the patient and the family, from the time of evaluation through post-discharge. Additionally, a Liver Transplant Support Group, facilitated by the social worker, provides both inpatients and outpatients with a comfortable place to share questions, concerns and experiences.
A registered clinical dietician evaluates the nutritional status and helps with any related problems. The dietician helps the patient and the family to understand the nutritional needs and restrictions. Some patients are placed on a special diet, and the nutritionist will help educate the patient about best food practices. If the appetite is poor, the nutritionist will provide nutritional supplements to increase the caloric intake.
It is not uncommon for patients with liver disease facing a transplant or those who have already undergone transplantation (or their families) to have difficulty in dealing with their hospitalization and/or illness. Psychosocial help and guidance is especially important for patients who have dealt with addiction issues in the past.
It is very important to for patients to be on a physical therapy program in the months and weeks before transplant. Regular breathing exercises and exercise for the limbs help in maintaining muscle mass and are an essential component of the recovery process after transplant. Special exercise programs are supervised by a physical therapist. These exercise programs are designed specifically for transplant patients. The physical therapy program has to be continued after the patient leaves the hospital.