Originally Published In
Critical Care Nursing Clinics of North America
Liver transplantation has become the standard of care for the treatment of a variety of liver diseases that in the past would have resulted in an early death. According to the United Network for Organ Sharing (UNOS) there are currently 14,433 candidates waiting for a liver transplant in the United States. A total of 7,841 liver transplants were performed in the United States in 2016. Despite increased education regarding organ donation and advances in patient management, there continues to be a gap in the supply and demand of organs for transplant. Due to this scarce resource, pre and post- transplant patient management remains a key focus in achieving optimal outcomes. Transplant medicine is a highly complex, specialized field, requiring specialized knowledge and management of the patient in the pre-transplant phase and the early post -transplant period. Patients requiring a liver transplant often are managed in the outpatient setting but can require intensive care placement for acute liver failure or decompensated end stage liver disease (ESLD). Critical care nurses play a role in the care of these patients. The best patient outcomes occur when expertise and experience coincide. The purpose of this article is to provide critical care nurses with an overview of liver disease and transplantation for adult patients with a diagnosis of liver failure.