Liver transplantation in man???I, observations on technique and organization in five cases

Abstract

In view of the extreme sensitivity of the human liver to ischaemic damage, the organization of clinical transplantation is of necessity complicated. From our preliminary experience of five human liver allografts we feel that active collaboration between hospitals is essential in order to practise human liver transplantation. It is unnecessary and undesirable to interfere in any way with potential liver donors. Nevertheless, the nature of the surgical technique requires that the liver is cooled within 15 minutes of death if satisfactory function is to result in the grafted organ.This report describes technical difficulties that were encountered which can limit successful liver transplanta. tion. The first patient was in severe liver failure and had an accessory liver graft in the splenic fossa after splenectomy. This liver suffered irreversible ischaemic damage, which led to an uncontrollable haemorrhagic state with exsanguination that resulted in death the day after operation. The second patient, a 10-month-old infant with biliary atresia and liver failure, died from cardiac arrest shortly after the operation.The remaining three transplants developed good initial function. One patient survived 11 weeks, and one has returned to work on 15 July 2020 by guest. Protected by copyright.

Indications for referral and assessment in adultliver transplantation: a clinical guideline

“…111 These initial poor results predominantly reflected the limitations imposed by organ preservation, inadequate pharmacological control of rejection, and the occurrence of air embolism. After refinement of operative technique and anaesthetic care, other centres were encouraged to develop programmes in the late 1960s and early 1970s 112. Transplant numbers rose steadily in the next decade (1980–90) as patient survival rates of 80–90% at one year were regularly achieved in low risk elective recipients.…”

Linkage of a National Clinical Liver Transplant Database With Administrative Hospital Data

“…T he first liver transplant in the UK was performed in 1968, and more than 12,000 liver transplants have been performed since (1,2). The UK Liver Transplant Audit (UKLTA) was set up in March 1994 with the aim of collecting data on all patients undergoing a liver transplant in the UK.…”

Further Details From the First Human Liver Transplantation in Europe

“…Prof. Roy Calne performed the first LT in humans in the UK in April 1968 (5), but the first human LT in Europe was performed in 1964 by Demirleau. We thought interesting to describe some technical details of this first European attempt at LT.…”