Pre PACES Podcast #107 Liver transplant
Feb 16, 2025
Dr. Emma Saunsbury, a hepatology fellow at the John Radcliffe Hospital, specializes in liver transplant and complex liver cases. She dives into the intricacies of liver transplant examinations, sharing techniques for identifying candidates and managing post-transplant care. Emma discusses the importance of risk scores like MELD and Child-Pugh in assessing patients, and she offers insights into tailored management strategies for septic and transplant patients. With a focus on adaptability in consultations, she emphasizes how patient care must meet individual needs.
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Initial Patient Assessment
- Observe the patient for general well-being and signs of illness.
- Look for specific transplant signs like medication packets (e.g., tacrolimus) and physical characteristics (e.g., jaundice, Cushingoid features).
Hand Examination
- Check for a coarse tremor, which is associated with tacrolimus use.
- Examine for skin cancers, a risk with long-term immunosuppression.
Facial Examination
- Look for jaundice in the sclera, a sign of potential graft dysfunction.
- Check for gum hypertrophy or hirsutism, potential side effects of cyclosporine.