2020 Volume 55 Issue 1 Pages 33-38
【Background】 Liver transplant recipients occasionally need long-term hospitalization due to liver dysfunction from chronic rejection, recurrence of primary diseases, or other illnesses such as malignant tumors. On such occasions, however, it is not always possible for transplant centers to satisfy the recipients’ and their families’ requests due to limited capacity. Here, we report a case who needed long-term hospitalization due to liver failure from chronic rejection and wished for home care- based follow-up. Further, the role of recipient transplant coordinators in its implementation is discussed.
【Design】 Case report.
【Managements and Results】 The patient is a 60-year old female who had undergone a living donor liver transplantation for fulminant hepatic failure. Fifteen years after the operation, she developed liver failure due to chronic rejection, characterized mainly by repeated hepatic encephalopathy. The patient and her family rejected the treatment option of re-transplantation, and hoped for home care-based follow-up instead. To establish the follow-up system, the recipient transplant coordinators first managed the conferences with medical doctors, nurses, pharmacists, and nutritionists. As a result, the problems of the patient and her family could be shared, and all medical professionals could work as a team to achieve the treatment goal. Second, the coordinators organized a support system with the regional medical facilities including visiting nurses and a nearby hospital. Eventually, her home care-based treatments were successfully established.
【Conclusion】 As the age of recipients increases and as the number of long-term survivors grows, cooperation with multifactorial medical professionals and collaboration with community resources become crucial and indispensable. Early action is necessary and would contribute to sustainable care in patients’ residential areas. Recipient transplant coordinators play an important role for its implementation.
