**6. Preoperative checklist**

The preoperative evaluation concludes with a review of all pertinent studies and information obtained from investigative tests.

	- **•** Careful review of the patient's medications is important.
	- **•** The aim is to judiciously give medications that control the patient's illnesses and at the same time minimizing the risk associated with anesthetic and other drugs interactions.
	- **•** In general, patients taking cardiac drugs, pulmonary drugs or anticonvulsants, antihypertensives, or psychiatric drugs are advised to take their medications with sips of water on the morning of operation.
	- **•** Parenteral medications are used if the patient remains NPO for any significant period postoperatively.

Hypoxemia at rest is the prerequisite for the diagnosis. Medical management is disappointing,

Malnutrition is common with liver impairment and is a risk factor for mortality following LT. Nutritional supplementation has not been proven to affect outcome. The total amount of calories provided should be at least 30-35 kcal/kg/day. Adults can receive daily 1-2 g protein/ kg of dry body weight. Patients should take daily multivitamin and other supplements as needed. Specific fat-soluble vitamin supplements are provided if a deficiency is present.

The preoperative period can be extremely stressful. Declining health, uncertainty about the results, and inability to continue working and participating in daily activities may increase the risk of depression and/or anxiety. Patients with chronic HCV have a greater incidence of depression and anxiety. Patients who experience significant psychological distress have

The preoperative evaluation concludes with a review of all pertinent studies and information

**1.** Informed consent after discussion with the patient and family members regarding the indication for the anticipated surgical procedure, as well as its risks and proposed benefits

**3.** Antibiotic prophylaxis: The appropriate antibiotic is chosen before surgery and adminis‐

**•** The aim is to judiciously give medications that control the patient's illnesses and at the same time minimizing the risk associated with anesthetic and other drugs interactions.

**•** In general, patients taking cardiac drugs, pulmonary drugs or anticonvulsants, antihypertensives, or psychiatric drugs are advised to take their medications with sips

**•** Parenteral medications are used if the patient remains NPO for any significant period

and liver transplant is advocated as the treatment of choice.

**5.12. Malnutrition**

16 Recent Advances in Liver Diseases and Surgery

**5.13. Psychosocial stress**

increased complications.

**6. Preoperative checklist**

obtained from investigative tests.

**5.** Revision of medications

postoperatively.

**2.** Review the need for β-blockade, DVT prophylaxis

**4.** Preoperative mechanical bowel cleansing, whenever indicated

**•** Careful review of the patient's medications is important.

tered before the skin incision is made

of water on the morning of operation.
