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Contraindications


                                                                                  Liver Transplantation: Version 7.0

Contraindications


Solid Organ Transplantation: General Contraindications
        •    Active infection
        •    Malignant disease - patients should be tumor-free for at least five years
              prior to consideration for transplantation (this may vary by center and by
              type of cancer)
        •    HIV positive (this may vary by center)
        •    Active peptic ulcer disease
        •    Active drug, tobacco or alcohol abuse
        •    Severe, irreversible organ system damage other than organ to be transplanted
        •    Evidence of psychopathology
        •    Inability to understand the procedure or the risks involved or comply with
              follow-up care
        •    History of failure to comply with medical regimen
        •    Lack of functional psychosocial support system
        •    Lack of financial resources to pay for surgery, hospitalizations, medications
              and follow-up care

Liver Transplantation: Absolute Contraindications 4
        •    Compensated cirrhosis
        •    Active alcohol or drug abuse
        •    Extrahepatic malignancy
        •    Infection outside the biliary tract
        •    Advanced cardiopulmonary disease (including pulmonary hypertension that
              cannot be controlled with medical therapy)
        •    Multisystem organ failure
        •    Anatomic abnormalities that preclude performing the surgical procedure of
              liver transplantation

Liver Transplantation: Relative Contraindications
        •    Inadequate social or family support
        •    Advanced age (over 65, although many centers have adopted a “physiologic
              age” approach which leads to transplants of candidates into their 70’s)
        •    Hepatopulmonary syndrome with PO2 < 50 mmHg; although the
              hepatopulmonary syndrome may be reversible with OLT, hypoxemia this
              severe is associated with increased risk post-transplant
        •    Intrahepatic tumor > 5 cm
        •    Spontaneous bacterial peritonitis or other bacterial infection on adequate
              treatment