Abstract
Liver transplantation (LT) has evolved from a semi-experimental procedure in the 1960s to become a routine intervention with excellent results in patients with both acute and chronic liver diseases. Improvements and innovations in surgical technique, graft preservation and patient selection have led to increase in indications for LT, including some conditions that only a few years ago would have been considered absolute contraindications. The progressive change in indications for LT such as the increase in non-alcoholic fatty liver disease and hepatocellular carcinoma has led to an increased focus on long-term outcomes and the notion of transplant benefit when selecting candidates. New selection and allocation systems have been developed to maximize these outcomes by matching patients to suitable grafts. Post-transplant management in the early phase is concerned mainly with surgical, infective and immunological complications whilst long-term management focuses on reducing the risk to the patient from the complications of immunosuppression such as cardiovascular disease and cancers.
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Bibliography
Starzl TE, Marchioro TL, Vonkaulla KN, Hermann G, Brittain RS, Waddell WR. Homotransplantation of the liver in humans. Surg Gynecol Obstet. 1963;117:659–76. PMID: 14100514; PMCID: PMC2634660.
Adam R, Karam V, Delvart V, O’Grady J, Mirza D, Klempnauer J, Castaing D, Neuhaus P, Jamieson N, Salizzoni M, Pollard S, Lerut J, Paul A, Garcia-Valdecasas JC, RodrĂguez FS, Burroughs A. All contributing centers (www.eltr.org); European Liver and Intestine Transplant Association (ELITA). Evolution of indications and results of liver transplantation in Europe. A report from the European Liver Transplant Registry (ELTR). J Hepatol. 2012;57(3):675–88. https://doi.org/10.1016/j.jhep.2012.04.015. Epub 2012 May 16. PMID: 22609307.
Neuberger J, James O. Guidelines for selection of patients for liver transplantation in the era of donor-organ shortage. Lancet. 1999;354(9190):1636–9. https://doi.org/10.1016/S0140-6736(99)90002-8. PMID: 10560692.
Tschuor C, Ferrarese A, Kuemmerli C, Dutkowski P, Burra P, Clavien PA, Liver Allocation Study Group. Allocation of liver grafts worldwide—is there a best system? J Hepatol. 2019;71(4):707–18. https://doi.org/10.1016/j.jhep.2019.05.025. Epub 2019 Jun 12. PMID: 31199941.
Mergental H, Laing RW, Kirkham AJ, Perera MTPR, Boteon YL, Attard J, Barton D, Curbishley S, Wilkhu M, Neil DAH, HĂĽbscher SG, Muiesan P, Isaac JR, Roberts KJ, Abradelo M, Schlegel A, Ferguson J, Cilliers H, Bion J, Adams DH, Morris C, Friend PJ, Yap C, Afford SC, Mirza DF. Transplantation of discarded livers following viability testing with normothermic machine perfusion. Nat Commun. 2020;11(1):2939. https://doi.org/10.1038/s41467-020-16251-3. PMID: 32546694; PMCID: PMC7298000.
ELTR. http://www.eltr.org/Overall-indication-and-results.html. Accessed 17 Oct 2021.
Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, Montalto F, Ammatuna M, Morabito A, Gennari L. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996;334(11):693–9. https://doi.org/10.1056/NEJM199603143341104. PMID: 8594428.
Duvoux C, Roudot-Thoraval F, Decaens T, Pessione F, Badran H, Piardi T, Francoz C, Compagnon P, Vanlemmens C, Dumortier J, Dharancy S, Gugenheim J, Bernard PH, Adam R, Radenne S, Muscari F, Conti F, Hardwigsen J, Pageaux GP, Chazouillères O, Salame E, Hilleret MN, Lebray P, Abergel A, Debette-Gratien M, Kluger MD, Mallat A, Azoulay D, Cherqui D, Liver Transplantation French Study Group. Liver transplantation for hepatocellular carcinoma: a model including α-fetoprotein improves the performance of Milan criteria. Gastroenterology. 2012;143(4):986–94.e3; quiz e14–5. https://doi.org/10.1053/j.gastro.2012.05.052. Epub 2012 Jun 29. PMID: 22750200.
Mathurin P, Moreno C, Samuel D, Dumortier J, Salleron J, Durand F, Castel H, Duhamel A, Pageaux GP, Leroy V, Dharancy S, Louvet A, Boleslawski E, Lucidi V, Gustot T, Francoz C, Letoublon C, Castaing D, Belghiti J, Donckier V, Pruvot FR, Duclos-Vallée JC. Early liver transplantation for severe alcoholic hepatitis. N Engl J Med. 2011;365(19):1790–800. https://doi.org/10.1056/NEJMoa1105703. PMID: 22070476.
Lee BP, Mehta N, Platt L, Gurakar A, Rice JP, Lucey MR, Im GY, Therapondos G, Han H, Victor DW, Fix OK, Dinges L, Dronamraju D, Hsu C, Voigt MD, Rinella ME, Maddur H, Eswaran S, Hause J, Foley D, Ghobrial RM, Dodge JL, Li Z, Terrault NA. Outcomes of early liver transplantation for patients with severe alcoholic hepatitis. Gastroenterology. 2018;155(2):422–30.e1. https://doi.org/10.1053/j.gastro.2018.04.009. Epub 2018 Apr 12. PMID: 29655837; PMCID: PMC6460480.
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Gupta, R., O’Beirne, J. (2022). Liver Transplantation. In: Cross, T. (eds) Liver Disease in Clinical Practice. In Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-031-10012-3_17
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