Advertisment Fosfocin
Indian Journal of Critical Care Medicine
An open access publication of ISCCM™ 
Users online: 1744 
     Home | Login 
  About Current Issue Archive Search Instructions Online Submission Subscribe Etcetera Contact  
  Next article
  Previous article 
  Table of Contents
   Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
   Article in PDF (617 KB)
   Citation Manager
   Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
* Registration required (free) 

  IN THIS Article

 Article Access Statistics
    PDF Downloaded385    
    Comments [Add]    
    Cited by others 1    

Recommend this journal


Year : 2010  |  Volume : 14  |  Issue : 2  |  Page : 106-107

Critical care issues in liver transplantation

Immunodeficiencies Unit, Hospital 12 octubre. Carretera Andalucia km 5,400. Postal Code: 28041. Madrid, Spain

Date of Web Publication9-Aug-2010

Correspondence Address:
Luis Ignacio Gonzalez-Granado
Immunodeficiencies Unit. Hospital 12 octubre. Carretera Andalucia km 5,400. Postal Code: 28041. Madrid
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-5229.68232

Rights and Permissions

How to cite this article:
Gonzalez-Granado LI. Critical care issues in liver transplantation. Indian J Crit Care Med 2010;14:106-7

How to cite this URL:
Gonzalez-Granado LI. Critical care issues in liver transplantation. Indian J Crit Care Med [serial online] 2010 [cited 2018 Apr 20];14:106-7. Available from:

Dear Editor,

I read with keen interest the review by Gopal et al. in the journal. [1] I am grateful for their great review. However, I would like to make some comments.

First, there are recent reports that demonstrate the superiority of quadruple or triple immunosupression versus traditional approach in terms of efficacy and safety. [2] This positive outcome is mainly related to the use of tacrolimus as the cornerstone within the immunosuppressive treatment. [3]

Second, in areas where Chagas disease is endemic, with migratory flows, reactivation should be considered when the donor has Latin-American origin, nowadays this complication has been recognized in USA and Europe. [4],[5]

Third, the authors missed the important issue that transplant recipients may develop severe infection with Streptococcus pneumoniae, even in the early postransplant period. [6] Vaccination has been recommended in heart, renal and liver recipients. Available vaccines are the 23-valent polysaccharide and the hepta- and decavalent protein conjugate. [7]

  References Top

1.Gopal PB, Kapoor D, Raya R, Subrahmanyam M, Juneja D, Sukanya B. Critical care issues in adult liver transplantation. Indian J Crit Care Med 2009;13:113-9.  Back to cited text no. 1  [PUBMED]  Medknow Journal  
2.Lu AW, Zheng SS, Wu J, Liang TB, Wang WL, Shen Y, et al. Dual, triple, and quadruple oral tacrolimus-based immunosuppression regimens after orthotopic liver transplantation: a randomised comparative study of regimens. Zhonghua Yi Xue Za Zhi 2006;86:3389-92.  Back to cited text no. 2  [PUBMED]    
3.Jonas S, Neuhaus R, Junge G, Klupp J, Theruvat T, Langrehr JM, et al. Primary immunosuppression with tacrolimus after liver transplantation: 12-years follow-up. Int Immunopharmacol 2005;5:125-8  Back to cited text no. 3      
4.Souza FF, Castro-E-Silva O, Marin Neto JA, Sankarankutty AK, Teixeira AC, Martinelli AL, et al. Acute chagasic myocardiopathy after orthotopic liver transplantation with donor and recipient serologically negative for Trypanosoma cruzi: a case report. Transplant Proc 2008;40:875-8  Back to cited text no. 4      
5.D'Albuquerque LA, Gonzalez AM, Filho HL, Copstein JL, Larrea FI, Mansero JM, et al. Liver transplantation from deceased donors serologically positive for Chagas disease. Am J Transplant 2007;7:680-4.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]  
6.Engelhard D, Cordonnier C, Shaw PJ, Parkalli T, Guenther C, Martino R, et al. Early and late invasive pneumococcal infection following stem cell transplantation: a European Bone Marrow Transplantation survey. Br J Haematol 2002;117:444-50.  Back to cited text no. 6  [PUBMED]    
7.Duchini A, Goss JA, Karpen S, Pockros PJ. Vaccinations for Adult Solid-Organ Transplant Recipients: Current Recommendations and Protocols. Clin Microbiol Rev 2003;16:357-64.  Back to cited text no. 7  [PUBMED]    

This article has been cited by
1 Primary abdominal tuberculosis presenting as peritonitis in a young child-managed surgically
Singal, R. and Gupta, S. and Gupta, S.
Asian Pacific Journal of Tropical Medicine. 2012; 5(5): 413-415


Print this article  Email this article
Previous article Next article
Online since 7th April '04
Published by Wolters Kluwer - Medknow