History of Liver Transplantation

  • John R. Klinck
  • Ernesto A. Pretto


Thomas Starzl (1926–2017) began clinical liver transplantation in Denver, CO USA in 1963, soon followed by Roy Calne (1930–) in Cambridge UK. These two surgical pioneers built multidisciplinary teams and collaborated closely over the following two decades, overcoming enormous technical, biological and societal obstacles to establish transplantation as the only curative treatment for most forms of end-stage liver disease. The procedure was widely accepted by the mid-1980s, and today more than 25,000 liver transplants are performed each year worldwide.

This achievement involved tireless effort, intelligent use of advances in other fields, and occasional serendipity, but was also built on decades of work by others. This chapter will outline the early, hard-won advances in vascular surgery, immunology, organ preservation, and transplantation of the kidney that preceded successful liver transplantation, and will describe the further evolution of liver transplantation in the...


Rejection Immunosuppression Surgical technique Organ preservation Brain death Caval anastomosis 


  1. 1.
    Hamilton D. A history of organ transplantation. Pittsburgh: University of Pittsburgh Press; 2012. p. 105–25.Google Scholar
  2. 2.
    Matevossian E, Kern H, Hüser N, Doll D, Snopok Y, Nährig J, Altomonte J, Sinicina I, Friess H, Thorban S. Surgeon Yurii Voronoy (1895–1961) – a pioneer in the history of clinical transplantation: in memoriam at the 75th anniversary of the first human kidney transplantation. Transpl Int. 2009;22(12):1132–9.CrossRefGoogle Scholar
  3. 3.
    Hamilton DN, Reid WA. Yuri Voronoy and the first human kidney allograft. Surg Gynecol Obstet. 1984;159(3):289–94.PubMedGoogle Scholar
  4. 4.
    Bradley JA, Hamilton DN. Organ transplantation: an historical perspective. In: Hakim NS, Danovitch GM, editors. Transplantation surgery. London: Springer Verlag; 2001.Google Scholar
  5. 5.
    Le Gallois, M (Julien Jean Cesar), 1770–1814; translated by N.C. and J.G. Nancrede. Experiments on the principle of life, and particularly on the principle of the motions of the heart, and on the seat of this principle: including the report made to the first class of the institute, upon the experiments relative to the motions of the heart. Book, Microform in English; 1813.Google Scholar
  6. 6.
    Miller DJ. Sydney ringer; physiological saline, calcium and the contraction of the heart. J Physiol. 2004;555(Pt 3):585–7.CrossRefGoogle Scholar
  7. 7.
    Toledo-Pereyra LH. A study of the historical origins of cardioplegia. Dissertation/Thesis in English; 1984.Google Scholar
  8. 8.
    Malinin TI. Remembering Alexis Carrel and Charles Lindbergh. Heart Inst J. 1996;23(1):28–35.Google Scholar
  9. 9.
    Murray JE, Lang S, Miller BJ, et al. Prolonged functional survival of renal autografts in the dog. Surg Gynecol Obstet. 1956;103:15.PubMedGoogle Scholar
  10. 10.
    Belzer FO, Boston MD, Sterry Ashby B, Englebert Dunphy J. 24-hour and 72-hour preservation of canine kidneys. Lancet. 1967;290(7515):536–9.CrossRefGoogle Scholar
  11. 11.
    Toledo-Pereyra LH, Simmons RL, Najarian JS, Condie RM. Effective use of silica gel fraction for kidney preservation after 2-yr room storage. Surg Forum. 1976;27(62):311–2.PubMedGoogle Scholar
  12. 12.
    Collins GM, Bravo-Shugarman M, Terasaki PI. Kidney preservation for transportation. Initial perfusion and 30 hours’ ice storage. Lancet. 1969;2(7632):1219–22.CrossRefGoogle Scholar
  13. 13.
    Belzer FO, D’Alessandro AM, Hoffmann RM, Knechtle SJ, Reed A, Pirsch JD, Kalayoglu M, Sollinger HW. The use of UW solution in clinical transplantation: a 4-year experience. Ann Surg. 1992;215(6):579–85.CrossRefGoogle Scholar
  14. 14.
    Gubernatis G, Pichlmayr R, Lamesch P, Grosse H, Bornscheue A, Meyer HJ, Ringe B, Farle M, Bretschneider HJ. HTK-solution (Bretschneider) for human liver transplantation. Langenbecks Arch Chir. 1990;375(2):66–70.CrossRefGoogle Scholar
  15. 15.
    Welch CS. A note on transplantation of the whole liver in dogs. Transplant Bull. 1955;2:54–5.Google Scholar
  16. 16.
    Starzl TE, Demetris AJ. Liver transplantation: a 31-year perspective. Chicago: Year Book Medical Publishers; 1990.Google Scholar
  17. 17.
    Calne RY, editor. Liver transplantation: the Cambridge-King’s college hospital experience. London: Grune and Stratton; 1983.Google Scholar
  18. 18.
    National Institutes of Health consensus development conference statement: liver transplantation – June 20–23, 1983. Hepatology. 1984;4:107S–10S.Google Scholar
  19. 19.
    Shaw BW Jr, Martin DJ, Marquez JM, Kang YG, Bugbee AC Jr, Iwatsuki S, Griffith BP, Hardesty RL, Bahnson HT, Starzl TE. Venous bypass in clinical liver transplantation. Ann Surg. 1984;200(4):524–34.CrossRefGoogle Scholar
  20. 20.
    Carmichael FJ, Lindop MJ, Farman JV. Anaesthesia for hepatic transplantation: cardiovascular and metabolic alterations and their management. Anesth Analg. 1985;64:108–16.CrossRefGoogle Scholar
  21. 21.
    Marquez J, Martin D, Virji MA, Kang YG, Warty VS, Shaw B Jr, Sassano JJ, Waterman P, Winter PM, Pinsky MR. Cardiovascular depression secondary to ionic hypocalcemia during hepatic transplantation in humans. Anesthesiology. 1986;65(5):457–61.CrossRefGoogle Scholar
  22. 22.
    Krowka MJ, Mandell MS, et al. Hepatopulmonary syndrome and portopulmonary hypertension: a report of the multicenter liver transplant database. Liver Transpl. 2004;10(2):174–82.CrossRefGoogle Scholar
  23. 23.
    Walia A, Schumann R. The evolution of liver transplant practices. Curr Opin Organ Transplant. 2008;13(3):275–83.CrossRefGoogle Scholar
  24. 24.
    Gelman S, Dillard E, Bradley EL Jr. Hepatic circulation during surgical stress and anesthesia with halothane, isoflurane, or fentanyl. Anesth Analg. 1987;66(10):936–43.CrossRefGoogle Scholar
  25. 25.
    Groth CG. Changes in coagulation. In: Starzl TE, Putnam CW, editors. Experience in hepatic transplantation. Philadelphia: W B Saunders; 1969. p. 159–75.Google Scholar
  26. 26.
    Aldrete JA. Anesthesia and intraoperative care. In: Starzl TE, Putnam CW, editors. Experience in hepatic transplantation. Philadelphia: W B Saunders; 1969. p. 83–111.Google Scholar
  27. 27.
    Kang YG, Martin DJ, Marquez J, Lewis JH, Bontempo FA, Shaw BW Jr, Starzl TE, Winter PM. Intraoperative changes in blood coagulation and thrombelastographic monitoring in liver transplantation. Anesth Analg. 1985;64(9):888–96.CrossRefGoogle Scholar
  28. 28.
    Mandell MS, Stoner TJ, Barnett R, Shaked A, Bellamy M, Biancofiore G, Niemann C, Walia A, Vater Y, Tran ZV, Kam I. A multicenter evaluation of safety of early extubation in liver transplant recipients. Liver Transpl. 2007;13(11):1557–63.CrossRefGoogle Scholar
  29. 29.
    Garcea G, Nabi H, Maddern GJ. Russell strong and the history of reduced-size liver transplantation. World J Surg. 2009;33(8):1575–80.CrossRefGoogle Scholar
  30. 30.
    Busuttil RW. International liver transplantation society 2009 presidential address: the internationalization of liver transplantation. Liver Transpl. 2010;16:558–66.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Perioperative CareCambridge University HospitalsCambridgeUK
  2. 2.Division of Transplant and Vascular AnesthesiaUniversity of Miami Leonard M Miller School of Medicine, Jackson Memorial HospitalMiamiUSA

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