The other common cause of death in our series is sepsis, which occurred in six patients. A significant number of these were related to pulmonary sepsis in the form of overwhelming pneumonia. These cases presented early on in the program, when our patients were cared for in a mixed surgical medical unit, where septic techniques were not strictly followed. After the first year of the program, our patients were nursed in an isolated unit with compliance to septic techniques observed while in the intensive care unit. This dramatically decreased the number of pneumonia cases and, therefore, the number of deaths related to pulmonary sepsis.
Liver transplantation is a technically demanding procedure.
Patients are usually very morbid to start with. The combination of portal hypertension and coagulopathy makes the procedure challenging, requiring precise surgical techniques to avoid severe hemorrhage. Following the hepatectomy, precise anastomotic techniques are required to construct the vascular and biliary anastomoses. Technical error may lead to devastating results in such an immunocompromised patient. Technical complications in our series have been below the reported average, however, they led to mortality in cases of hepatic artery thrombosis.