Who should perform liver transplantation? Should that be the transplant surgeon, the hepatobilary surgeon, or the general surgeon?

Sixth Forum on Liver Transplantation. Center approach to liver diseases. Is it worthwhile?

“…The corollary of the question is how should such a surgeon be trained? Desai and Kuo argue for the 'transplant' surgeon [3]. Their main arguments rely on the particular knowledge of the transplant surgeon for complex vascular reconstruction, on immunology and the use of immuno-suppressive drugs.…”

Part II: The Hepatobiliary Surgeon

“…While there have been no studies evaluating the impact offellowship training on transplantation outcomes, there clearly is a positive association between surgical volume and experience with outcomes [12] (see article from Delco in this Forum). In fact, there is a study demonstrating that transplant surgeons experienced with living donor liver transplantation had less morbidity compared to HPB surgeons in major hepatectomy for hepatocellular cancer [13]. It is generally well accepted that experience leads to improved patient care and outcome.…”