SERVICE:
DATE:
DATE OF BIRTH:
ATTENDING PHYSICIAN:
Pediatric Liver and Intestinal Transplant
August 25, 2006
April 7, 1996
William Berquist, M.D.
This is a report of the minutes of the Pediatric Liver and Intestinal
Transplant Selection Committee. The committee met on August 25, 2006.
attendance were:
1. Carlos O. Esquivel, M.D., Ph.D.
2. C. Andrew Bonham, M.D.
3. Waldo Concepcion, M.D.
4. Tito Monge, P.A.-C.
5. Sarah Iversen, P.A.
6. Jason Vanatta, M.D.
7. Eric Sibley, M.D.
8. Anita Tallisetti, M.D.
9. James Lue, M.D.
10. Allison Wong, M.D.
11. Marcia Castillo, R.N., B.S.N.
12. Michelle Alvia-Emerson
13. Jennifer Nielson, M.S.N., F.N.P.
14. Carmela Alviar, M.S.N.
15. Chris Dong, M.S.W.
16. Rebecca Sullivan
17. Makoto Ogihara, M.D.
18. Sameera Mian, M.D.
In
Xxxxxx is a 10-year-old male status post liver transplant for biliary atresia
in 1997. He has a history of biliary cirrhosis after his transplant. He also
has a right lower lobe empyema status post right lower lobe lobectomy. He was
recently admitted to Lucile Packard Children's Hospital with a presentation of
coffee-grounds and bloody emesis. While he was hospitalized he underwent an
EGD with banding of esophageal varices. Liver biopsy performed approximately
one year ago revealed a cirrhotic liver secondary to biliary cirrhosis. While
Xxxxxx was hospitalized he underwent an upper endoscopy and was noted to have
varices in the distal esophagus and the varices were banded. Xxxxxx was also
noticed to have a thrombus within the portal vein. A hematology consult was
obtained to rule out a hypercoagulability disorder, although this does not
appear to be a problem. He also a pulmonary consult to evaluate his history
of right lower lobectomy. They ordered a CT of the chest and started the
patient on albuterol twice a day giving pulmonary clearance for liver
transplantation with the diagnosis of reactive airway disease. The Surgical
Transplant Team also evaluated Xxxxxx during his hospitalized and performed
the necessary CT scans needed for a repeat transplant. Xxxxxx was discussed
in our selection meeting as on August 25, 2006, and the multidisciplinary
meeting determined that Xxxxxx is in need of a second liver transplant.
Therefore, the decision was made at this time to list Xxxxxx with a weight
range of 10 to 30 kg.