DISCHARGE SUMMARY

HPB/Liver Transplant
Bahria International Hospital Orchard Lahore.
PROF DR.HUMA ARSHAD CHEEMA Dr. FAISAL HANIF
Hepatologist & Gastroenterologist Liver Transplant Surgeons

MR. No WEL-251 Date of Admission 23 Nov2020

Name AMINA ARSHAD Date of Operation 27 Nov ,2020

Age 15Yrs Date of Discharge 16 Dec,2020

Sex Female Blood Group B+ve

Height 156cm Weight 66.5kg

MELD Score CTP Score/ Child

Status

Email Id Phone No

Referred By PROF DR.HUMA ARSHAD

CHEEMA

Donor Name Age/Sex 25Yrs/Male

Relation brother Blood Group B+ve

Diagnosis :
Operation :
History :
Past History :
 DISCHARGE SUMMARY
HPB/Liver Transplant
Bahria International Hospital Orchard Lahore.
Medication :
Addiction / Habituation:

Physical Examination at Admission

Physical Examination:

Vitals:
CNS :
CVS :
Chest :
Abdomen:
Genito Urinary:

Pre Transplant Assessment (Date)

Hematology
HB (gm/dl) HCT TLC(/cumm) PLT(/cumm) FDP HBA1C

PT(seconds) INR APTT(seconds) Fibrinogen D-Dimmer

Biochemistry

T.Bil(mg/dl) S.GOT(IU/L) S.GPT(IU/L) ALP(IU/L) GGT(IU/L) T.protien(gm/dl) ALB(gm/dl)

Urea(mg/dl) Creatinine(mg/dl) Na(meq/dl) K(meq/dl) Phosphate Ca(mg/dl) Mg(mg/dl)

(mg/dl)
 DISCHARGE SUMMARY
HPB/Liver Transplant
Bahria International Hospital Orchard Lahore.

Thyroid Function Tests:

TSH (uu / ml):
T3 (pg/ml):
Lipid Profile:
LDL (mg/dl): Sr Cholesterol (mg/dl):
TGL (mg/dl): HDL (mg/dl):

Viral Markers
HBsAg : HBcAb: -
HBeAb : HBV DNA:
Anti HCV ab: HCV RNA (Quantitative): HCV
Genotype: HIV I:
HIV II:
CMV IgG:
Autoimmune Markers
ANA:
UPPER GI ENDOSCOPY
Esophagus
Stomach
Duodenum
Band Ligation

Tumor Markers
AFP (IU/ml): CEA (ng/ml):
CA (19-9): CA 125 (Female Patients):
Copper Studies
Sr.Cerulopasmin (mg/dl):
 DISCHARGE SUMMARY
HPB/Liver Transplant
Bahria International Hospital Orchard Lahore.
Iron Studies
G6PD Level: TIBC (ug/dl):
Sr Iron (ug/dl):
Urine studies
Urine R/M: - Urine protein:
Creatinine ratio: - Peak Creatinine Level: -
24 hours urinary studies
Total creatinine (mg/dl):
Ascetic fluid Examination
Cell count: - % Neutrophils: -
Glucose: - Protein: SAAG: - -
Cytology for malignant: - -
ADA - AFB: -
Cultures
Grams stain: - U-Organism (if positive)
Urine: - -Organism (if positive)
Blood: -
Ascetic fluid: - A-Organism (if positive)
Liver Doppler
Coarse echo texture: - Ascites: -
Patent PV: - liver SOL: -
PV Flow
Triple contrast CT/MRI
Shrunken Liver: - Liver SOL:
HCC: - No.of lesions
Location of lesions:
Diameter of largest:
Tumor: Total tumor diameter
 DISCHARGE SUMMARY
HPB/Liver Transplant
Bahria International Hospital Orchard Lahore.
Within ICSF PV invasion:
HV/IVC invasion: Ascites: -
PV thrombus:
Extent of thrombus:
Large collaterals: - spleno-renal: -
Spleno-gastric: - Coronary vein: -
Retroperitoneal: - -
Cardiorespiratory studies
CXR: Hydrothroax:
Parenchymal:
Remarks (if any):
ECG
Remarks (if any)
PFT, s :
FEV1:- Predicted%:-
FVC: - Predicted%:-
FEV1/FVC: - Nil
ABG
PH: PO2: PCO2:
O2 sat:
2-D ECHO:
LA: - EF: - CVP
DSE
Bubble contrast:
 DISCHARGE SUMMARY
HPB/Liver Transplant
Bahria International Hospital Orchard Lahore.

Pre-operative course

Operative Detail:
Findings
Liver Morphology ()
Liver Mass/HCC (site, size, number):
Portal vein thrombus: -
Lymphadenopathy: -
Ascites: -
Lienorenal shunts /:
Collaterals: -
Addition Findings:
Graft 1 Details
Graft type: -
Graft weight (gm.): - Cold ischemia time: -
Reconstruction
Bench work:
Right Hepatic Venous anastomosis: -
Middle Hepatic venous Anastomosis:
Inferior Hepatic venous Anastomosis: -
Portal venous Anastomosis: -
 DISCHARGE SUMMARY
HPB/Liver Transplant
Bahria International Hospital Orchard Lahore.
Hepatic arterial Anastomosis: -
Biliary anastomosis: -

Additional procedures: -
.

Histopathology of Explant Liver: (Path No – S – 9398/16)

Postoperative course
 DISCHARGE SUMMARY
HPB/Liver Transplant
Bahria International Hospital Orchard Lahore.

Investigations
POD-1 POD-3 POD-5 POD-7 POD-14 AT DC
HB (gm/dl)
HCT (%)
TLC ( /cumm)
PLT ( /cumm)
Urea (mg/dl)
Creatinine (mg/dl)
Na (meq/dl)
K (meq/dl)
Phosphate (mg/dl)
Ca (mg/dl)
Mg (mg/dl)
T.Bil (mg/dl)
S.GOT (IU/L)
S. GPT (IU/L)
ALP (IU/L)
GGT (IU/L)
T. Protein (gm/dl)
ALB (gm/dl)
PT ( seconds)
INR
APTT ( seconds)
Fibrinogen

Tacrolimus / Cyclosporine Levels

POD3
 DISCHARGE SUMMARY
HPB/Liver Transplant
Bahria International Hospital Orchard Lahore.
POD7
POD11

Graft US Doppler
Hepatic IHB PV PV PV flow HA RI HV Pleural Ascites
parenchyma RD patency Velocity pattern patency flow
effusion

POD1 Patent Patent

POD3 Patent Patent
POD5 Patent Patent

Final discharge slip checked by:

 DISCHARGE SUMMARY
HPB/Liver Transplant
Bahria International Hospital Orchard Lahore.

Gastroenterologist/Hepatologist:

Head of Department: