Transplantation of the Liver

Current Clinical Status of the Extracorporeal Liver Support Devices

The liver is a vital organ with more than 500 functions, including protein synthesis, detoxification, regulation, metabolic functions, and biliary production. Liver failure, whether occurring without preexisting liver disease (acute liver failure [ALF]) or as an acute decompensation of a…

Extracorporeal Perfusion for Resuscitation of Marginal Grafts

Principles of Organ Preservation and Machine Perfusion Interrupting the blood flow to an organ is an unavoidable step in the transplantation process. Even when the procedures in the donor and the recipient are perfectly coordinated, a period of ischemia necessarily…

Ischemia-Reperfusion Injury in Liver Transplantation

Liver transplantation is the standard of care in patients with end-stage liver disease and those with tumors of hepatic origin. In 2011 there were 16,107 patients in the United States waiting for a liver transplant, but only 6341 transplants were…

Stem Cells and Liver Regeneration

The liver has an amazing regenerative capacity, which can especially be observed in response to toxic injury and infection. However, in patients with certain hepatic conditions such as cirrhosis, steatosis, and conditions due to age—where liver matrix and cells are…

Liver and Hepatocyte Xenotransplantation

A severe shortage of human livers for allotransplantation has sparked interest over the years in the potential use of animals in lieu of humans as a source of livers—that is, xenotransplantation. Besides offering a plentiful supply of livers, xenotransplantation might…

Genetic and Genomic Potential in Liver Transplantation

In 1953 Watson and Crick published in Nature the double helix structure of DNA. The following year Joseph Murray performed the first successful human kidney transplant on identical twins, which was published 2 years later in the Journal of the…

Survival and Quality of Life in Children

Human liver transplantation was first attempted in 1963 in a child with biliary cirrhosis resulting from extrahepatic biliary atresia. At the time such patients were considered to be the best candidates for liver transplantation because there were no other options…

Long-Term Functional Recovery and Quality of Life

In 1983, after review of over 500 cases, the National Institutes of Health issued a consensus statement establishing liver transplantation (LT) as an effective and durable therapy for adults and children with end-stage liver disease. Before this event the procedure…

U.S. Trends in Transplantation

The success and evolution of liver transplantation as a therapeutic treatment for patients with advanced liver disease led to a National Institutes of Health–sponsored Consensus Development Conference, which recommended that a “registry or clearinghouse be established for collection and evaluation…

Outcome Predictors in Transplantation

Orthotopic liver transplantation (OLT) is a durable and the definitive lifesaving treatment modality for patients suffering from irreversible liver failure. Although thousands of patients receive liver transplants each year, the limited organ supply remains a reality, and many patients are…