New livers | |
Medical care of the liver transplant patient. Killenberg PG, Clavien PA (editors). Malden, MA: Blackwell Science 1997 (xvi+409 pp.). ISBN: 0 86542 524 8. |
This is a
succinct book devoted to the medium and long term care of liver transplant recipients in a community-based setting. As the editors state in the introduction, such a concept is long overdue -- liver transplantation has become almost routine practice for patients with terminal liver disease. The book seeks to identify and discuss common problems. As such, it provides a platform for general practitioners and physicians caring for patients outside major liver transplant centres. The 24 chapters discuss the selection and evaluation of patients who may need a transplant, including psychiatric issues and the problems of alcoholic liver disease. The postoperative issues of allograft rejection, infection, osteoporosis, hypertension, renal dysfunction, cardiovascular risk factors, rehabilitation and interactions with immunosuppressive drugs are all very pertinent to primary care physicians; less relevant are chapters on histopathology, fulminant hepatic failure and surgical issues. The book is limited by its all-American authorship, particularly with regard to financial issues and allocation of donor organs, and the price of $150 is a little excessive. Overall, this is an excellent handbook that will be an asset to those involved in the care of liver transplant patients. It is a valuable guide for GPs and primary care physicians as well as a reminder to specialist hepatologists of the essential issues. Geoff McCaughan
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