A Liver Transplant Case

A 39-year-old male with chronic liver disease, marked by jaundice, abdominal distension, pedal edema, and a history of hypertension, underwent a successful liver transplant on April 7, 2023, with his wife as the donor. The pre-operative investigations revealed significant abnormalities, including Hb (6.2 g/dl), TLC (11930 cells/cu.mm), Platelets (150000 cells/cu.mm.), and INR (4.43). Peripheral smear was normocytic normochromic anemia with relative neutrophilia and thrombocytopenia. Serum bilirubin (9.9 mg/dl), Serum creatinine (0.87 mg/dl), Serum Sodium (127 mmol/J), Serum potassium (3.0 mmol/J), serum bilirubin (25.5 mg/dl), and albumin (3.1 g/dl). Urine culture showed ESBL E. coli growth following his admission, and he was managed with an IV antibiotic (Meropenem) for 5 days. Examination of the cardiovascular, respiratory, and nervous systems was normal. The operation notes described a challenging surgery with a shrunken cirrhotic liver, dense adhesions, and successful anastomoses of the graft's venous and arterial structures. The recipient's post-transplant plan involved several follow-up appointments, including the frequency of visits, initially every 4 days for the first 4 visits, then every 15 days for the next 2 visits, and subsequently monthly. The patient was discharged on April 29, 2023, with detailed post-discharge advice, a prescribed diet, and a list of medications, including immunosuppressants (Prograf, Certican, Cellcept, Prednisolone), other medications (Tenofovir Alafenamide, Amlong, Valcyte, Pantop, Ecosprin, Syp Cremaffin, Becoz'nc/Becosules - Z, Uvogen, Matilda Forte, Shelcal M, Hepsure Sachet).