A review of liver transplantation for the dentist and guidelines for dental management

Resident: Roberts
Article: A review of liver transplantation for the dentist and guidelines for dental management
Author: Glassman, Paul. Et al
Journal: Special Care in Dentistry
Volume # 13 No. 2 pages 74 – 80
Year: 1993
The American Council of Transplantation states that a “successful transplant is one in which there is normal organ function one year after the transplant procedure.”
Chronic Liver Disease and Fulminant Hepatic Failure are the primary indications for a liver transplant. Imunosuppressive therapy is vital to postoperative success. However, a fine balance must be achieved in order to retain a healthy immune system and a successful graft. Infection is the most frequent cause of mortality and morbidity in liver transplant patients. Within the first 6 months most infections are related to the cytomegalovirus and after 6 months most infections are bacterial. Prior to transplant, dentist should be cautious about liver complications when regarding treatment. Definitive treatment should be performed prior to transplantation and the dentist should be aware of conditions such as PT, PTT. In the presence of ascites use prophylactic antibiotics for invasive procedures to avoid risk of infection. After transplantation, the dentist should consider steroid supplementation prior to stressful dental procedures such as extractions. Drugs such as acetaminophen, narcotics, lidocaine and other LA’s, barbiturates, and antibiotics should be used only after consultation with the patients physician and should be used conservatively. The main focus of the dentist at this point should be preventative and care should be taken so that infections do not occur and spread systemically.

Conclusion: Always know your med hx. BAZAam!