Intestinal and multivisceral transplantation have evolved significantly over the last three decades. A better understanding of the pathophysiology, improvements in surgical techniques and perioperative management, availability of effective immunosuppression (IS), and above all the experience of the last few decades…
Necrotic liver tissue, whether before or after liver transplantation, is a serious condition that requires immediate attention, because it can result in considerable morbidity or mortality. Although the most effective treatment for a massively necrotic liver is liver replacement, the…
The last 30 years have demonstrated dramatic improvements in survival outcomes following liver transplantation and thus have allowed liver transplantation to be established as the standard of care for adult and pediatric patients with end-stage liver disease or hepatic malignancy.…
Irreversible kidney failure was once considered an absolute contraindication to liver transplantation alone. Three decades ago the first combined liver and kidney transplantation (CLKT) was performed by Margreiter et al. Interestingly, the recipient, a 32-year-old man with hepatitis B cirrhosis, had…
Portal vein thrombosis (PVT) is defined as a partial or complete occlusion of the blood flow within the portal vein by an intraluminal thrombus. Balfour and Stewart first described this process in the literature in 1868 in a patient who…
Reconstruction of the hepatic artery is one of the principal technical challenges in orthotopic liver transplantation, and successful patient and allograft outcomes depend on robust, uninterrupted arterial flow into the newly implanted liver. Because oxygen is delivered to the allograft's…
Liver transplantation has become the standard of care for many types of end-stage liver disease. Dr. Thomas Starzl performed the first successful deceased donor liver transplantations (DDLTs) in the 1960s, but DDLT would not move from experimental to therapeutic status…
Historical Background The first attempted and successful living donor liver transplants were undertaken in 1989 in the in Brazil and Australia. In the face of a scarcity of deceased donor liver grafts, living donor liver transplantation (LDLT) took a preeminent…
The benefit of liver transplantation among patients with end-stage liver disease cannot be disputed in the modern era. However, access to a deceased donor liver allograft remains an extremely challenging problem that has prevented expansion of this medical advance to…
The shortage of cadaveric liver grafts has stimulated the development of innovative surgical procedures with various forms of living donor liver transplantation (LDLT), especially in adult patients, which produce satisfactory results comparable to whole-liver deceased donor liver transplantation (DDLT). For…