Indications, Evaluation, and Allocation for Liver Transplantation

In the most simplistic view, liver transplantation is indicated for patients with irreversible liver injury. The United States statistics on death reveal that 400,000 individuals have endstage liver disease and 26,050 die of liver disease each year. However, only 18,444 of these patients are listed for liver transplantation and 4,954 undergo liver transplantation annually. The 18,000 patients on the transplant list (1) have liver diseases in which liver transplant has been shown to significantly prolong life and (2) have been identified, through a careful evaluation process, as having acceptable comorbid disease, compliance, and social support requirements. The patients who actually undergo transplantation are determined by the allocation system for organ donors.