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Liver Transplantation: An Overview

University of Wisconsin School of Medicine, Mrl{at}medicine.wisc.edu

The first human liver transplant was performed by Thomas Starzl in Denver in 1963. In the United States, the 5-year survival rate after liver transplantation is 75%, but many patients with liver disease die without ever having had transplantation because of a shortage of organs. Mortality rates are significantly higher in centers that perform 20 transplants or fewer annually. Liver transplantation is appropriate for almost all liver diseases. The decision to transplant is based on 1) assessment of the severity of liver failure; 2) the patient's prognosis on medical treatment; 3) quality of life; and 4) the potential of transplantation to restore patient health. The number of transplants is limited by the availability of donor organs. In 2000 in the United States, there were 17,000 patients on the waitng list; 4579 cadaveric and 371 living related transplants were performed. There were 1347 deaths on the waiting list.

Key Words: liver transplantation • split liver grafts • PERV • marginal donors • extended use organs

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