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Liver Disorders pp 599–619Cite as

Liver Transplantation: An Overview

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Abstract

Orthotopic liver transplantation (OLT) is a definitive life-saving treatment for irreversible liver failure and specific types of liver and bile duct cancers in the absence of systemic metastasis. Donor availability is the principal limiting factor for expansion of OLT. With scarcity of organs for transplantation, the current Model for End-Stage Liver Disease/Pediatric End-Stage Liver Disease (MELD/PELD) liver allocation system prioritizes the organ based on medical urgency to decrease patient death rate while on the liver transplant waiting list. In short, the deceased donor liver graft is allocated to the sickest patient on the waiting list based on the patient’s MELD score.

Long-term patient survival outcomes after orthotopic liver transplantation (OLT) are excellent largely because of surgical innovations and advances in peri- and intraoperative management and immunosuppression regimens. The rate of patient recovery is generally dependent of the patient’s acuity of illness prior to OLT, operative factors, and hepatic allograft function. After primary (first time) OLT, 10–22 % of OLT recipients would require retransplantation of the liver (ReLT) due to various reasons. The most common early causes of graft failure leading to ReLT are primary nonfunction (PNF), delayed nonfunction or initial poor function, and vascular complications while chronic rejection and recurrence of primary liver disease are common late causes of graft failure. This chapter aims to address common general topics in the current clinical practice of liver transplantation.

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Author information

Authors and Affiliations

  1. Division of Transplant Surgery, Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Suite E5700, Milwaukee, WI, 53226, USA

    Joohyun Kim M.D., Ph.D. & Johnny C. Hong M.D., F.A.C.S.

  2. A Joint Program of Froedtert & Medical College of Wisconsin, Children’s Hospital of Wisconsin & Blood Center of Wisconsin, 9200 W. Wisconsin Ave., Suite E5700, Milwaukee, WI, 53226, USA

    Johnny C. Hong M.D., F.A.C.S.

Authors
  1. Joohyun Kim M.D., Ph.D.
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  2. Johnny C. Hong M.D., F.A.C.S.
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Correspondence to Johnny C. Hong M.D., F.A.C.S. .

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Editors and Affiliations

  1. Division of Gastroenterology and Hepatology, Medical College of Wisconsin , Milwaukee, Wisconsin, USA

    Kia Saeian

  2. Division of Gastroenterology and Hepatology, Medicine Medical College of Wisconsin , Milwaukee, Wisconsin, USA

    Reza Shaker

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© 2017 Springer International Publishing Switzerland

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Kim, J., Hong, J.C. (2017). Liver Transplantation: An Overview. In: Saeian, K., Shaker, R. (eds) Liver Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-30103-7_36

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  • DOI: https://doi.org/10.1007/978-3-319-30103-7_36

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-30103-7

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