Case Studies

J. B. (renal transplant-acute care)
B. W. (liver transplant-acute care)
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Date: June 24, 2001
Place: University Hospital
Unit: Surgery Wing

Patient: L. S.

6/19/01

L.S. is a 37yo WF with end-stage liver disease secondary to cryptogenic cirrhosis diagnosed in 1996. Pt. has been transferred to the abdominal transplant service in preparation for a cadaveric liver transplant. PMH: ascites, encephalopathy, portal hypertension and hypothyroidism. Meds on admission include Aldactone 200mg qd, Furosemide 40mg BID, Lactulose 30 mls QID, Propranolol 20mg BID and Levoxyl 0.025ug QD. She previously was admitted to the MICU for respiratory decompensation and worsening encephalopathy. She was placed on broad spectrum antibiotics, Zosyn and Cipro based on TA culture of Pseudomonas aeruginosa. She has received antibiotics for past eleven days and will continue for a total of fourteen days. L.S. has improved over this time and was transferred to the medical ward service. Vital signs and lab values are stable. Pt. is CMV antibody (-) and donor is CMV antibody (-).

6/20/01

Patient underwent cadaveric OLT with no significant complications. Currently in SICU with stable vital signs and good urine output. Patient started on postoperative transplant medications, including preoperative antibiotics Zosyn and Cipro, which will be continued for another three days. Plan to extubate and transfer out of SICU by tomorrow if patient continues to improve.

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