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Medical Care of the Liver Transplant Patient
December 2012
PRINT AND DIGITAL MEDIA REVIEWS
Medical Care of the Liver Transplant Patient. Pierre-Alain Clavien and James Trotter, editors. 490 pp. $179.95. New York, New York, Wiley, 2012. ISBN: 978-14443-3591-0. Web address for ordering: www.wiley.com
REVIEW RATING Coverage of relevant topics
夝夝夝夝夝
Improvement over previously available media
夝夝夝夝
Style of presentation and formatting
夝夝夝夝夝
Quality of figures
夝夝夝夝
Overall
夝夝夝夝
Stars: 夝: poor; 夝夝: adequate; 夝夝夝: fair; 夝夝夝夝: good; 夝夝夝夝夝: excellent.
The remarkable success of liver transplantation in extending the life of patients previously thought unsalvageable by standard care has resulted in the proliferation of transplant programs throughout the world. No longer is care of a patient requiring a liver transplant or in one returning from a successful transplant a rarity. The need for guidance in the care of these patients has stimulated several books that review the principles of liver transplantation. Medical Care of the Liver Transplant Patient, now in its 4th edition and edited by Drs Clavien and Trotter, has successfully filled the need. Since the 3rd edition, published in 2006, the book has been extensively revised with the addition of 16 new chapters. The editors have assembled an international group of authors, each recognized experts in their own field. The editors have provided careful oversight in matters of style and largely eliminated overlapping of topic content. The aim of the book is to address the important areas involved in the spectrum of care before and after transplantation. The quality, quantity, and presentation of tables, charts, and graphs are appropriate, but the lack of color in the photographs is disappointing. The book is in hardback format with excellent paper quality. I particularly liked the key learning points that headed each individual chapter. The index was well constructed and helpful. All of the areas relevant to the aim of the book are covered in appropriate depth. The section on pediatric transplantation, although well written, is so abbreviated that it is almost an afterthought. Pediatricians will need to consult additional sources for more in-depth coverage. The essential points in Part 1, “The medical care of the pre-transplant patient,” are covered in some depth. Chap-
1689
ter 1, which covers the selection and evaluation of the recipient, was complete and addressed the general approach in each disease category. The topic of retransplantation was included in this chapter. Given its increasing importance, a more detailed examination of the controversy surrounding retransplantation would have been desirable. Chapter 7, discussing organ allocation, ethics, and organ supply, was an important addition to the book. The senior author has been one of the most thoughtful persons involved in the discussions surrounding organ distribution and allocation. The operative approach to transplantation is covered in a more general manner. Surgeons interested in more detail would need to consult more specialized sources. Surgeons have developed ingenuous surgical techniques to compensate for the shortage of available organs, including living donors, split livers, donors after cardiac death, and domino transplants. Each donor category with its advantages and complications is discussed in individual chapters. A major development has been the use of extended donors. Chapter 17 provides an excellent overview. The subsection on the donor risk index is especially valuable as it relates to underlying donor concomitant risk factors. This allows more accurate prediction of graft survival. In a more perfect world, the use of recognized donor risk factors would allow matching of donor and recipient for optimum results. Chapter 21, which discusses difficult surgical patients, is unique to this book and presents the accumulated wisdom of the senior editor on individual preoperative problems that in the past have been relative contraindications to liver transplantation. The usual issues involving care in the perioperative period are covered in adequate depth. Immunosuppression and rejection are covered in broad brush in Chapter 27. An invaluable strength of this chapter is the impact of specific immunosuppressive agents on donor characteristics and the resultant medical problems that occur posttransplantation. Chapter 31 discusses the metabolic syndrome resulting from immunosuppression. Pretransplant morbidities adversely impact patient morbidity and mortality following transplantation. This is particularly so for renal failure induced by immunosuppression and all too often preceded by renal dysfunction prior to transplantation. The topic of renal failure is discussed in Chapter 4, Chapter 31, and finally in Chapter 27 as part of the overview of immunosuppression management. Given the importance of renal failure in the overall picture of liver transplantation, future editions should consider a separate chapter focusing solely on the renal aspects of transplantation. Bottom Line: This book is directed to the general physician, gastroenterologist/hepatologist, and surgeon who want a current overview of liver transplantation. The transplant physician and surgeon will find it a useful reference. The book as intended squarely meets its target
1690
PRINT AND DIGITAL MEDIA REVIEWS
GASTROENTEROLOGY Vol. 143, No. 6
audience. I can recommend the book with enthusiasm. It will find a place on my bookshelf. MICHAEL F. SORRELL Department of Medicine University of Nebraska Lincoln, Nebraska
Clinical Dilemmas in Inflammatory Bowel Disease: New Challenges, 2nd edition. Peter Irving, Corey A. Siegel, David Rampton, and Fergus Shanahan, editors. 294 pp. $84.95. New York, New York, Wiley, 2012. ISBN: 978-1-44433454-8. Web address for ordering: www.wiley.com
REVIEW RATING Coverage of relevant topics
夝夝夝夝夝
Improvement over previously available media
夝夝夝夝
Style of presentation and formatting
夝夝夝夝夝
Quality of figures
夝夝夝夝
Overall
夝夝夝夝夝
Stars: 夝: poor; 夝夝: adequate; 夝夝夝: fair; 夝夝夝夝: good; 夝夝夝夝夝: excellent.
The aim of Clinical Dilemmas in Inflammatory Bowel Disease: New Challenges is to address some of the most challenging questions and issues in the management of patients with inflammatory bowel disease (IBD). This is the second edition of this text and is almost completely revised and different from the first edition. This book achieves its goal and more. The IBD clinician will find succinct discussions, by recognized experts, of the most difficult issues that we face in IBD management today. This book should be made readily available in any clinic involved in the care of IBD patients. The book is divided into 9 major sections, including genetics, infection, evaluation, medical therapy, other treatments, surgical issues, unsolved issues in IBD, nutrition, and management processes. There are a total of 57 distinct topics/questions that are tackled in this text. Each chapter starts with a question followed by a boxed summary of the learning points. The question is then discussed in 3– 4 pages including references. The data presented are to the point and where appropriate evidence based. The short, direct, concise
chapters and relevance of the dilemmas presented make this text easy to navigate and read. Topics such as “What to do about hepatitis B and hepatitis C in patients with IBD” and “Thiopurines in the sun: What should be done?” are examples of topics that have direct impact on the day-to-day care of the IBD patients that are not normally seen in the standard IBD text. Because of the nature of the text, the coverage of the topics is not exhaustive but is actually perfect for the busy clinician who has a specific question in IBD management. Each topic can be easily read in about 5–10 minutes. References are provided for more in-depth review. Despite the fact that each chapter is written by a different author, there is marked uniformity among the chapters. Each chapter is written by experts on the particular question being asked and there is a mixture of European and American authors, which enhances the material presented. The text is a soft cover with 284 pages including the front material. There are no color figures in the book. Charts and algorithms are provided in about 63% of the chapters and enhance the text material. The text size is small, making it a bit more difficult to read quickly; however, because most readers will be focusing on 1 question at a time, this does not detract from the overall quality of the book. The surgical topics may have benefited by the addition of some figures to complement the written material. This is a second edition and ⬎75% of the material is completely new, with other topics extensively updated. The material presented is up-to-date and adds significantly to the rapidly changing field of IBD management. A few of the treatment chapters may more rapidly become out of date owing to the significant movement of IBD management; however, the way that the questions are asked will allow most of the chapters to continue to provide important information for the IBD clinician, such as “IBD standards: Will they enhance patient care?” There is some overlap with the Curbside Consultation in IBD Series (SLACK, 2009), with a few authors presenting similar topics, such as communicating risks of biologic therapy; however, most of the questions differ and with the rapidly changing IBD field, information presented is new and framed in our current climate of IBD care. Bottom Line: Clinical Dilemmas in Inflammatory Bowel Disease: New Challenges targets the IBD clinician and is a practical, well-written, easy-to-use text that will be invaluable to all involved in the care of IBD patients, including gastroenterologists, nurses, colorectal surgeons, and dieticians. Trainee gastroenterologists will find this text useful both in IBD management and as a source for IBD clinical presentations. I highly recommend this text for anyone who is engaged in the day-to-day clinical care of patients with IBD. KIM L. ISAACS Division of Gastroenterology and Hepatology University of North Carolina at Chapel Hill Chapel Hill, North Carolina
PRINT AND DIGITAL MEDIA REVIEWS
Medical Care of the Liver Transplant Patient. Pierre-Alain Clavien and James Trotter, editors. 490 pp. $179.95. New York, New York, Wiley, 2012. ISBN: 978-14443-3591-0. Web address for ordering: www.wiley.com
REVIEW RATING Coverage of relevant topics
夝夝夝夝夝
Improvement over previously available media
夝夝夝夝
Style of presentation and formatting
夝夝夝夝夝
Quality of figures
夝夝夝夝
Overall
夝夝夝夝
Stars: 夝: poor; 夝夝: adequate; 夝夝夝: fair; 夝夝夝夝: good; 夝夝夝夝夝: excellent.
The remarkable success of liver transplantation in extending the life of patients previously thought unsalvageable by standard care has resulted in the proliferation of transplant programs throughout the world. No longer is care of a patient requiring a liver transplant or in one returning from a successful transplant a rarity. The need for guidance in the care of these patients has stimulated several books that review the principles of liver transplantation. Medical Care of the Liver Transplant Patient, now in its 4th edition and edited by Drs Clavien and Trotter, has successfully filled the need. Since the 3rd edition, published in 2006, the book has been extensively revised with the addition of 16 new chapters. The editors have assembled an international group of authors, each recognized experts in their own field. The editors have provided careful oversight in matters of style and largely eliminated overlapping of topic content. The aim of the book is to address the important areas involved in the spectrum of care before and after transplantation. The quality, quantity, and presentation of tables, charts, and graphs are appropriate, but the lack of color in the photographs is disappointing. The book is in hardback format with excellent paper quality. I particularly liked the key learning points that headed each individual chapter. The index was well constructed and helpful. All of the areas relevant to the aim of the book are covered in appropriate depth. The section on pediatric transplantation, although well written, is so abbreviated that it is almost an afterthought. Pediatricians will need to consult additional sources for more in-depth coverage. The essential points in Part 1, “The medical care of the pre-transplant patient,” are covered in some depth. Chap-
1689
ter 1, which covers the selection and evaluation of the recipient, was complete and addressed the general approach in each disease category. The topic of retransplantation was included in this chapter. Given its increasing importance, a more detailed examination of the controversy surrounding retransplantation would have been desirable. Chapter 7, discussing organ allocation, ethics, and organ supply, was an important addition to the book. The senior author has been one of the most thoughtful persons involved in the discussions surrounding organ distribution and allocation. The operative approach to transplantation is covered in a more general manner. Surgeons interested in more detail would need to consult more specialized sources. Surgeons have developed ingenuous surgical techniques to compensate for the shortage of available organs, including living donors, split livers, donors after cardiac death, and domino transplants. Each donor category with its advantages and complications is discussed in individual chapters. A major development has been the use of extended donors. Chapter 17 provides an excellent overview. The subsection on the donor risk index is especially valuable as it relates to underlying donor concomitant risk factors. This allows more accurate prediction of graft survival. In a more perfect world, the use of recognized donor risk factors would allow matching of donor and recipient for optimum results. Chapter 21, which discusses difficult surgical patients, is unique to this book and presents the accumulated wisdom of the senior editor on individual preoperative problems that in the past have been relative contraindications to liver transplantation. The usual issues involving care in the perioperative period are covered in adequate depth. Immunosuppression and rejection are covered in broad brush in Chapter 27. An invaluable strength of this chapter is the impact of specific immunosuppressive agents on donor characteristics and the resultant medical problems that occur posttransplantation. Chapter 31 discusses the metabolic syndrome resulting from immunosuppression. Pretransplant morbidities adversely impact patient morbidity and mortality following transplantation. This is particularly so for renal failure induced by immunosuppression and all too often preceded by renal dysfunction prior to transplantation. The topic of renal failure is discussed in Chapter 4, Chapter 31, and finally in Chapter 27 as part of the overview of immunosuppression management. Given the importance of renal failure in the overall picture of liver transplantation, future editions should consider a separate chapter focusing solely on the renal aspects of transplantation. Bottom Line: This book is directed to the general physician, gastroenterologist/hepatologist, and surgeon who want a current overview of liver transplantation. The transplant physician and surgeon will find it a useful reference. The book as intended squarely meets its target
1690
PRINT AND DIGITAL MEDIA REVIEWS
GASTROENTEROLOGY Vol. 143, No. 6
audience. I can recommend the book with enthusiasm. It will find a place on my bookshelf. MICHAEL F. SORRELL Department of Medicine University of Nebraska Lincoln, Nebraska
Clinical Dilemmas in Inflammatory Bowel Disease: New Challenges, 2nd edition. Peter Irving, Corey A. Siegel, David Rampton, and Fergus Shanahan, editors. 294 pp. $84.95. New York, New York, Wiley, 2012. ISBN: 978-1-44433454-8. Web address for ordering: www.wiley.com
REVIEW RATING Coverage of relevant topics
夝夝夝夝夝
Improvement over previously available media
夝夝夝夝
Style of presentation and formatting
夝夝夝夝夝
Quality of figures
夝夝夝夝
Overall
夝夝夝夝夝
Stars: 夝: poor; 夝夝: adequate; 夝夝夝: fair; 夝夝夝夝: good; 夝夝夝夝夝: excellent.
The aim of Clinical Dilemmas in Inflammatory Bowel Disease: New Challenges is to address some of the most challenging questions and issues in the management of patients with inflammatory bowel disease (IBD). This is the second edition of this text and is almost completely revised and different from the first edition. This book achieves its goal and more. The IBD clinician will find succinct discussions, by recognized experts, of the most difficult issues that we face in IBD management today. This book should be made readily available in any clinic involved in the care of IBD patients. The book is divided into 9 major sections, including genetics, infection, evaluation, medical therapy, other treatments, surgical issues, unsolved issues in IBD, nutrition, and management processes. There are a total of 57 distinct topics/questions that are tackled in this text. Each chapter starts with a question followed by a boxed summary of the learning points. The question is then discussed in 3– 4 pages including references. The data presented are to the point and where appropriate evidence based. The short, direct, concise
chapters and relevance of the dilemmas presented make this text easy to navigate and read. Topics such as “What to do about hepatitis B and hepatitis C in patients with IBD” and “Thiopurines in the sun: What should be done?” are examples of topics that have direct impact on the day-to-day care of the IBD patients that are not normally seen in the standard IBD text. Because of the nature of the text, the coverage of the topics is not exhaustive but is actually perfect for the busy clinician who has a specific question in IBD management. Each topic can be easily read in about 5–10 minutes. References are provided for more in-depth review. Despite the fact that each chapter is written by a different author, there is marked uniformity among the chapters. Each chapter is written by experts on the particular question being asked and there is a mixture of European and American authors, which enhances the material presented. The text is a soft cover with 284 pages including the front material. There are no color figures in the book. Charts and algorithms are provided in about 63% of the chapters and enhance the text material. The text size is small, making it a bit more difficult to read quickly; however, because most readers will be focusing on 1 question at a time, this does not detract from the overall quality of the book. The surgical topics may have benefited by the addition of some figures to complement the written material. This is a second edition and ⬎75% of the material is completely new, with other topics extensively updated. The material presented is up-to-date and adds significantly to the rapidly changing field of IBD management. A few of the treatment chapters may more rapidly become out of date owing to the significant movement of IBD management; however, the way that the questions are asked will allow most of the chapters to continue to provide important information for the IBD clinician, such as “IBD standards: Will they enhance patient care?” There is some overlap with the Curbside Consultation in IBD Series (SLACK, 2009), with a few authors presenting similar topics, such as communicating risks of biologic therapy; however, most of the questions differ and with the rapidly changing IBD field, information presented is new and framed in our current climate of IBD care. Bottom Line: Clinical Dilemmas in Inflammatory Bowel Disease: New Challenges targets the IBD clinician and is a practical, well-written, easy-to-use text that will be invaluable to all involved in the care of IBD patients, including gastroenterologists, nurses, colorectal surgeons, and dieticians. Trainee gastroenterologists will find this text useful both in IBD management and as a source for IBD clinical presentations. I highly recommend this text for anyone who is engaged in the day-to-day clinical care of patients with IBD. KIM L. ISAACS Division of Gastroenterology and Hepatology University of North Carolina at Chapel Hill Chapel Hill, North Carolina