Liver transplantation: Fifty years of experience

Abstract

Since 1963, when the first human liver transplantation (LT) was performed by Thomas Starzl, the world has witnessed 50 years of development in surgical techniques, immunosuppression, organ allocation, donor selection, and the indications and contraindications for LT. This has led to the mainstream, well-established procedure that has saved innumerable lives worldwide. Today, there are hundreds of liver transplant centres in over 80 countries. This review aims to describe the main aspects of LT regarding the progressive changes that have occurred over the years. We herein review historical aspects since the first experimental studies and the first attempts at human transplantation. We also provide an overview of immunosuppressive agents and their potential side effects, the evolution of the indications and contraindications of LT, the evolution of survival according to different time periods, and the evolution of methods of organ allocation.

Clinicopathologic characteristics of de novo nodular regenerative hyperplasia in pediatric liver transplant

“…OLT is the last treatment option for ESLD. Since the first OLT was performed, substantial progress has been achieved in the overall survival, with a 1‐year survival rate of approximately 30% in the 1970s to a current rate of 90% and a 5‐year survival rate exceeding 70% . In the pediatric population, the indications for OLT are divided into chronic liver disease and acute liver failure.…”

“…In the pediatric population, the indications for OLT are divided into chronic liver disease and acute liver failure. Biliary atresia remains the most common indication of the chronic liver disease indications, whereas autoimmune hepatitis and acetaminophen toxicity are the causes of the acute liver failure …”

Evolution of Liver Transplantation Program in Shiraz, Iran

“…Despite this improvement, there is still an excess risk of death in long-term survivors with an estimated loss of 7 years of life compared to 6 and age matched general population, with a greater difference in younger recipients (8).…”

Thromboelastometric Profile in Patients with Prothrombotic Risk Factors Undergoing Liver Transplantation

“…All patients were submitted to liver transplantation by the piggyback surgical technique [4,12]. During the surgery preconditions of hemostasis were maintained within adequate ranges: pH ≥ 7.3, Temperature ≥ 36°C, ionic calcium ≥ 1.1 mmol/L -1 and hemoglobin (Hb) ≥ 8 g/dL -1 .…”

“…Currently, there is a progressive reduction of perioperative blood loss due to advances in surgical skills, anesthetic management and coagulation monitoring in general [8][9][10][11][12].…”