A Quest for Enhanced Recovery After Liver Transplant at The Colombo North Center for Liver Disease: The First Decade

Cirrhosis is a significant contributor to non-communicable disease related deaths in Sri Lanka and the only cure for cirrhosis constitutes liver transplant. Nonalcoholic fatty liver disease (NAFLD) which is the hepatic component of the metabolic syndrome is the main aetiology of cirrhosis in patients presenting for liver transplant at CNCLD. Enhanced recovery after surgery (ERAS) is a concept originally adopted in colorectal surgery, and is a multimodal- multidisciplinary approach to perioperative care aiming to reduce perioperative surgical stress response and improve short-term outcome. Targeting improved outcome, components of ERAS have been incorporated in the perioperative care of liver transplant at the Colombo North Center for Liver Disease since 2016. Sri Lanka needs to define its own enhanced recovery after liver transplant (ERALT) protocols based on local data and audit performance.