Liver Transplantation in Adults

✍ Scribed by David H. Van Thiel; Robert R. Schade; Thomas E. Starzl; Shunzaburo Iwatsuki; Byers W. ; Shaw Jr .; Judith S. Gavaler; Marcus Dugas

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 462 KB
• Volume: 2
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840020517

✦ Synopsis

Human liver transplantation has been possible since 1967. We report our experience in 32 adult patients who received liver transplants at the University of Pittsburgh over a 16-month period. Survival data, method utilized for patient selection, costs, and morbidity of the procedure are discussed.

Orthotopic liver transplantation for humans with advanced liver disease has been possible since 1967 when the first extended survival of such a patient was reported. Since then, more than 400 procedures have been performed; the majority (360) were performed by two groups; one in London (Calne) and the other in the United States (Starzl). At the time of this writing, 237 orthotopic liver transplants have been performed by Starzl; 170 at the University of Colorado and 67 at the University of Pittsburgh. We report the results in adults at the University of Pittsburgh and discuss patient selection, morbidity, cost, and institutional commitment.

PATIENT SELECTION

From February 1, 1981 through May 30, 1982, 32 orthotopic liver transplants were performed in adults at the University of Pittsburgh School of Medicilie; the indications are shown in Table 1. The major indication, accounting for nearly one-third of the cases, was postnecrotic cirrhosis. The second and third most common indications for liver transplantation were advanced primary biliary cirrhosis and hepatocellular carcinoma respectively.

The 32 patients were selected from 115 individuals who were evaluated for liver transplantation. All were referred specifically for consideration for possible liver transplantation. Sixty-eight were considered acceptable candidates based upon the severity of liver disease and the absence of factors known to contradict transplantation.

The disease categories of the potential candidates is shown in Table 2. Of the 68 acceptable candidates, only one refused transplantation after having been accepted for this procedure.