Monday, 2 June 2008


what is the name of this scar?
what are the indication for liver transplant?
what is the most likely aetiology in this patient?

Any patient with documented fulminant hepatic failure, decompensated cirrhosis, or hepatocellular carcinoma within defined criteria (no single lesion greater than 5 cm or no more than three lesions, the largest ≤3 cm) is a potential candidate for liver transplantation.
Any patient with one of the defined complications of end-stage liver disease (eg ascites, variceal bleeding, encephalopathy or hepatocellular carcinoma) and/or a MELD score of 10 should be considered for referral to a transplant center.

BSG guidelines for liver transplant, click here


  1. the indications for liver transplantation can be classified into four broad categories:
    1. Acute liver failure (fulminant hepatic failure).
    2. Chronic liver failure.
    3. Metabolic liver disease.
    4. Liver cancer.
    5. Other metabolic diseases caused by liver based inborn errors of metabolism.

  2. Carl's surgical incision/scar

  3. this is a "mercedes scar" of liver transpantation

  4. 1. Roof-top incision (the scar does look like a roof top)
    2. ‘Mercedes’ Incision. This one was coined by Sir Roy Calne (read here:, NOT Mercedes Benz incision (Sir Roy only called it a Mercedes Incision)
    3. Chevron’s incision
    4. Bilateral Kocher’s incision
    5. Bilateral subcostal incision (when you don’t know the name of it, just describe it the best you can)