Late Postoperative Surgical Procedures

Liver allograft recipients have undergone a variety of successful surgical procedures in the late postoperative period.

Procedures performed include: hernia repair, skin grafts, hip replacement, excision of an acoustic neuroma, and a variety of biliary procedures. Although these patients may theoretically be at greater risk to wound healing and infectious complications, these risks usually do not outweigh routine treatment of surgically treated diseases.

During the perioperative period the recipients are given "stress dosages" of steroids (Hydrocortisone 100 mg IV q 8 hours X 2 days), and then return to the maintenance steroid dose (i.e., prednisone 10 to 20 mg per day). The morning cyclosporine dose is usually omitted prior to an elective surgical procedure, but the evening dose and all subsequent dosages must be administered. Because the patient many times is unable to tolerate oral intake, the doses must be delivered intravenously. The usual intravenous dose is one third of each oral dose. When the recipient can tolerate oral intake, preoperative medications are resumed.