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What disqualifies you from a liver transplant?

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Liver transplant candidates can be disqualified based on various medical and psychosocial factors. These factors include being too well, too sick, too old, or having comorbid medical or psychosocial conditions (Secunda et al., 2013). Specific contraindications for liver transplantation can include conditions such as recent extrahepatic malignancies, uncontrolled infections, severe pulmonary hypertension, substance abuse, severe alcoholic hepatitis, advanced cardiac disease, aggressive hepatosplenic alphabeta T-cell lymphoma, portal vein thrombosis, cholangiocarcinoma, metastatic colorectal cancer to the liver, and end-stage alcoholic liver disease (Morrell et al., 2019; Miserachs & Ng, 2016; Syed et al., 2020; Benedetti et al., 1999; “Fulminant Liver Failure Induced by Hepatosplenic αβ T-Cell Lymphoma”, 2003; Qu et al., 2022; Batey, 1996; Hagness, 2015; Kodali et al., 2022; Alavian et al., 2012; Ling et al., 2010; Amir et al., 2016; Lee et al., 2011). Additionally, factors like HIV seropositivity, hepatitis B virus infection, and diabetes mellitus can also impact candidacy for liver transplantation (Wall et al., 2019; Alavian et al., 2012; Ling et al., 2010).

In the context of liver transplantation, certain conditions are considered relative contraindications, such as preexisting diabetes mellitus, which can lead to higher morbidity and mortality post-transplantation (Ling et al., 2010). Moreover, the presence of extrahepatic infections, advanced pulmonary tuberculosis, and systemic conditions like hemophagocytic lymphohistiocytosis are also considered contraindications due to the risk of recurrence and poor outcomes (Donataccio et al., 2011; Amir et al., 2016). Furthermore, end-stage alcoholic liver disease has been historically viewed as a relative or absolute contraindication to liver transplantation in many centers (Batey, 1996; Schenker et al., 1990).

In summary, liver transplant candidacy can be affected by a range of medical and psychosocial factors, with specific conditions serving as contraindications due to their impact on transplant outcomes and patient survival. It is essential for transplant centers to carefully evaluate each candidate to ensure the best possible outcomes post-transplantation.

References:  #

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