Since the initial descriptions of successful deceased donor liver transplantation (LT) in the 1960s by Dr. Thomas Starzl (see Chapter 125 ), there has been tremendous change and growth in the field of transplantation. Advancements in organ preservation, immunosuppression, perioperative…
Overview Liver transplantation (LT) is considered standard of care for select patients with hepatocellular carcinoma (HCC) arising in the setting of cirrhosis (see Chapter 108A ). The role of LT in treatment of other malignancies arising in the liver such…
Cancer of a solid organ is an uncommon indication for organ transplantation, but hepatocellular carcinoma (HCC) is an important exception to that general rule (see Chapters 89 and 105 ). HCC is the most common tumor treated with whole-organ transplantation,…
Acute liver failure (ALF), formally known as fulminant hepatic failure, is a rare and devastating condition characterized by the development of encephalopathy and impaired synthetic liver function (international normalized ratio [INR] > 1.5) occurring within 26 weeks of acute-onset jaundice…
Introduction The Global Observatory on Donation and Transplantation estimates that more than 35,000 liver transplantations are performed annually worldwide, but the number of patients on the waiting list continues to exceed donor organ availability. Because of the continuous donor shortage,…
The first human orthotopic liver transplant was carried out by Starzl in 1963. In the subsequent two decades, only a relatively small number of patients received grafts, usually those who were moribund with end-stage disease, and survival results were disappointing.…
Allotransplantation, defined as the transfer of tissues between genetically nonidentical individuals, has evolved into a highly successful therapy for end-stage organ failure in the modern era. However, unless some modification of the recipient immune system is made, transplanted organs are…
Introduction Adequate oncologic margins and enough future liver remnant (FLR) with proper inflow and outflow are the pillars for any successful strategy in liver surgery (see Chapter 101 ). Given that tumor-free margin remains the mainstream of any oncologic surgery,…
The associating liver partition and portal vein (PV) ligation for staged hepatectomy (ALPPS) procedure is a modification of the two-staged liver resection combining two established surgical techniques: right portal vein ligation (PVL) and in situ splitting of the liver (ISS).…
Introduction Portal vein embolization (PVE) is the most common portal flow modulation procedure performed preoperatively to reduce the risk of extensive liver resection in patients with a small anticipated future liver remnant (FLR). PVE redirects portal blood flow to the…