Liver transplantation: Summary of the National Institutes of Health Consensus Development Conference (Volume 4, Number 7)

Abstract

Since performance of the first human orthotopic liver transplantation in 1963, over 540 such operations have been carried out in four medical centers in the United States and Western Europe. Additional liver transplantation procedures have been performed in other parts of the world, and more recently in several other American medical centers. Although extremely demanding and expensive, the operation has been shown to be technically feasible, and interpretable results have been reported from all four primary transplant centers. These clearly demonstrate that liver transplantation offers an alternative therapeutic approach which may prolong life in some patients suffering from severe liver disease that has progressed beyond the reach of currently available treatment and consequently carries a predictably poor prognosis. However, substantial questions remain regarding selection of patients who may benefit from liver transplantation; the stage of their liver disease at which transplantation should be performed; survival and clinical condition of patients beyond the initial year after transplantation; and overall long-range benefits and risks of transplantation in the management of specific liver diseases.