Clinical Developments and Current Immunological Research Approaches in Liver Transplantation

  • R. Pichlmayr
  • K. Wonigeit


It has only been within the last few years that liver grafting has gained world-wide interest and broad clinical application. The first phase of liver transplantation began 1967 with the first successful graft performed by T.E. Starzl in a child, and was followed by continous clinical employment of this procedure mainly by four centers (Denver/Pittsburgh, Cambridge, Hannover, Groningen) where, however, no more than 800 grafts were performed until 1983 [1, 2]. Since then more than 3000 liver transplants have been done in about 40 centers in Europe alone and an equal or even higher number in North America. The number of liver transplantations in Hannover and the distribution of the major groups are given in Fig. 1. During this development a marked improvement in results was achieved [3–7]. For some special indications and particularly in children, 1-year survival rates in the range of 80%–90% have been reached. For the majority of indication groups, however, the results are not so favorable and demonstrate that many problems still have to be solved. Although it is beyond any doubt that liver grafting is already a clinical treatment with high therapeutic value, its further development will depend very much on the success of current and future research activities in hepatology, organ preservation, evaluation of graft quality, and transplant immunology and immunosuppression.


Major Histocompatibility Complex Liver Transplantation Biliary Atresia Transplant Proc Bile Duct Carcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Scharschmidt BF (1984) Human liver transplantation: Analysis of data on 540 patients from four centers. Hepatology 4: 95–101CrossRefGoogle Scholar
  2. 2.
    Starzl TE, Iwatsuki C, van Thiel D, Gartner J, Zitelli B, Malatack J, Schade R, Shaw B, Hakala T, Rosenthal J, Porter K (1982) Evolution of liver transplantation. Hepatology 2: 614–636PubMedCrossRefGoogle Scholar
  3. 3.
    Starzl TE, Iwatsuki S, Shaw BW, Gordon RD, Esquivel C (1985) Immunosuppression and other nonsurgical factors in the improved results of liver transplantation. Semin Liver Dis 5: 334–343PubMedCrossRefGoogle Scholar
  4. 4.
    Caine RY, Williams R, Rolles K (1986) Liver transplantation in the adult. World J Surg 10: 422–431CrossRefGoogle Scholar
  5. 5.
    Pichlmayr R, Neuhaus P (1985) Lebertransplantation. Chirurg 56: 211–215PubMedGoogle Scholar
  6. 6.
    Pichlmayr R, Ringe B, Lauchart W, Wonigeit K (1987) Liver transplantation. Transplant Proc 19: 103–112PubMedGoogle Scholar
  7. 7.
    Burdelski M, Schmidt K, Bernsau U, Galaske R, Hoyer PF, Brodehl J, Brölsch Ch, Neuhaus P, Ringe B, Lauchart W, Wonigeit K, Pichlmayr R (1986) Transplantation im Kindesalter, Wiener Med Wschr 98: 551–555Google Scholar
  8. 8.
    Starzl TE, Iwatsuki S, Shaw BW, Gordon RD, Esquivel C (1986) Liver transplantation in the ciclosporin era. Progr Allergy 38: 366–394Google Scholar
  9. 9.
    Wonigeit K, Brölsch C, Neuhaus P, Burdelski M, Schmidt E, Lang W, Pichlmayr R (1983) Special aspects of immunosuppression with cyclosporine in liver transplantation. Transplant Proc 15: 2586–2591Google Scholar
  10. 10.
    Wonigeit K (1985) Pharmakokinetik von Ciclosporin A und Bedeutung der Blutspiegelmessung für die Therapie. Internist 26: 534–542PubMedGoogle Scholar
  11. 11.
    Quesniaux V, Tees R, Schreier MH, Wenger RM, Donatsch P, van Regenmortl MHV (1986) Monoclonal antibodies to ciclosporin. Progr Allergy 38: 108–122Google Scholar
  12. 12.
    Starzl TE, Iwatsuki S, Esquivel C, Todo S, Kam I, Lynch S, Gordon RD, Shaw BW (1985) Refinements in the surgical technique of liver transplantation. Semin Liver Dis 5: 349–356PubMedCrossRefGoogle Scholar
  13. 13.
    Neuhaus P, Brölsch C, Ringe B, Lauchart W, Pichlmayr R (1984) Results of biliary reconstruction after liver transplantation. Transplant Proc 16: 1225PubMedGoogle Scholar
  14. 14.
    Burdelski M, Lamesch P, Oellerich M, Raude E, Ringe B, Neuhaus P, Bortfeld S, Kämmerling C, Raith H, Westphal C, Worm M, Pichlmayr R (1987) Evaluation of quantitative liver function tests in liver donors. Transplant Proc (in press)Google Scholar
  15. 15.
    Lauchart W, Müller R, Pichlmayr R (1987) Immunoprophylaxis of hepatitis B virus reinfection in recipients of human liver allografts. Transplant Proc 19: 2387–2389PubMedGoogle Scholar
  16. 16.
    Steinhoff G, Wonigeit K, Ringe B, Lauchart W, Kemnitz J, Pichlmayr R (1987) Modified patterns of major histocompatibility complex-antigen expression in human liver grafts during rejection. Transplant Proc 19: 2466–2469PubMedGoogle Scholar
  17. 17.
    Wonigeit K, Bockhorn H, Pichlmayr R (1979) Posttransplant changes in specific precursor T-cell reactivity: comparison between liver and kidney allograft recipients. Transplant Proc 11: 1250–1255PubMedGoogle Scholar
  18. 18.
    Schwinzer R, Wonigeit K, Nashan B, Pichlmayr R (1987) Selective increase in CD8+ CD11+ cells in long-term liver allograft recipients. Transplant Proc (in press)Google Scholar

Copyright information

© Springer Verlag Berlin Heidelberg 1987

Authors and Affiliations

  • R. Pichlmayr
  • K. Wonigeit

There are no affiliations available

Personalised recommendations