Introduction

General philosophy of inpatient care

After 10 years of experience in liver and kidney transplantation surgery our conviction is that these patients require and deserve a unified, "one doctor" direction for their preoperative, operative, and early postoperative care. That responsibility falls squarely on the shoulders of the attending physician on the Transplantation Surgery Service. The attending physician acquaints himself with all aspect of the patient's medical and surgical problems. Although appropriate consultation is required, the synthesis and implementation of the total care for the transplant recipient falls to the Transplantation Surgery Service. Therefore, any questions one has concerning the early postoperative progress of the patient can be discussed with a member of the Transplantation Surgery Service with "up to the minute" details of all relevant medical information. Additionally, we have found that this system is helpful to the family and the recipient. The family members may talk daily with the same familiar physician with years of experience in liver transplantation. Furthermore, he can answer all questions pertinent to the patient's postoperative course, and can place the patient's progress in the context of the overall recovery. The fragmentary information which consultants tend to relate can be confusing to the family members who are already under tremendous psychological stress with a loved one recovering from a procedure of this magnitude.