Book Review

Abstract

Practical Manual of Abdominal Organ Transplantation. C. Manzarbeitia (Ed.). New York: Kluwer Academic/Plenum Publishers, 2002: 274 pp. The book ‘Practical Manual of Abdominal Organ Transplantation’ is aimed at being a quick and concise reference for medical students, residents, general practitioners, nurses and other paramedical staff involved in the care of transplant recipients. The manual reviews in systematic fashion the steps involved in patient work-up, management while on the waiting list, and the surgical procedure itself along with accompanying expected outcomes. Early and late complications are reviewed as well as commonly used immunosuppression medications. Chapter one is an overview of the indications for liver transplantation. Chapter two reviews patient evaluation for liver transplantation. Both chapters are good overviews however, there is significant overlap and in a concise reference manual they certainly could be combined into one chapter. Chapter three is an excellent guide to the management of the patient while on the waiting list for liver transplantation. Chapter four discusses the work-up for kidney and combined kidney/pancreas transplant. Chapters five and six describe the psychosocial work-up of the patient and in particular describe the roles for many of the paramedical staff involved in the patient work-up. This includes social workers, psychologists and the role of the transplant coordinators. Overall these chapters are likely very helpful to clarify the overall work-up process for someone new to the field of transplantation. Chapter seven briefly describes the organ donor allocation system within the United States. Chapters eight and nine discuss surgical techniques for liver, kidney and pancreas procurement. While there are six figures related to kidney retrieval, there are no figures related to liver retrieval, which might help to clarify the overall process of abdominal organ procurement. In a future edition these chapters could perhaps be combined to ease the readability for those unfamiliar with the process. The next three chapters provide a generalized overview of liver, kidney and pancreas recipient operations. Chapter 13 offers an excellent summary of anesthetic issues related to liver, kidney and pancreas transplants. Part four of the manual focuses on the postoperative care of liver, kidney and pancreas transplant recipients including an overview of immune-suppressive medications discussing the mechanism of action, side-effects and drug interactions. This section should provide a very useful introduction to resident and nursing staff faced with the sometimes intimidating task of assessing a decompensating post-transplant patient. Part five of the manual discusses the organ-specific late complications in transplantation and complications common to all transplant recipients. Chapter 20 provides a very concise overview of expected survival results for liver, kidney and pancreas transplants. Chapter 21 discusses the pathology involved in liver and kidney transplantation but does not discuss pathology in regards to pancreas transplantation. The final two chapters discuss the role of radiology and endoscopy in transplantation. All references are listed at the end of the book. Reference textbooks are suggested as well as reference articles and these are divided into groups of papers based on the chapter outline of the book. This grouping should aid in directing those interested to the seminal articles in the area. In addition, they have placed some important websites at the end of the book, which is useful information. Missing in this book on abdominal organ transplantation is any mention of intestinal transplantation or islet transplantation. Although these topics are relatively new and not as widely implemented as liver, pancreas and kidney transplantation they certainly deserve at least some mention as they will become increasingly applied. It is a difficult task to cover the entire field of abdominal organ transplantation in a single book. No matter how this is carried out it can always be criticized for lacking detail in some subjects and overemphasizing in others. On the other hand, a brief reference book is precisely what many of our training medical students and residents could benefit from. This manual is an excellent introduction to abdominal organ transplantation with a very broad overview that is as concise as is practically possible. This book can be highly recommended to its target audience of students, residents and paramedical staff.