Abstract
Medical management of the liver transplant recipient requires consideration of the
complex interactions between the transplanted liver, immunosuppression and all organ
systems. An aging transplant population, improvement in long-term liver transplant
outcomes, and the increase in nonalcoholic fatty liver disease as an indication for
transplant have amplified the number of co-morbidities among post-transplant patients.
In addition to balancing immunosuppression with infection risk, medical management
of the transplanted patient includes monitoring for, and treating, recurrence of the
primary liver disease, metabolic syndrome, cardiovascular disease, and post-transplant
neurologic and renal dysfunction. Additionally, general healthcare maintenance such
as management of osteoporosis, immunizations, and screening for malignancy are essential
in this high-risk population. In this review, we summarize the evidence behind best
practices for the current medical management of the post liver transplant patient.
Keywords
post-liver transplant - immunosuppression - graft loss
