Liver Transplant

About Liver Transplant

Liver transplantation replaces a diseased liver with a whole or partial liver from a donor. It is performed for end stage liver disease from causes such as alcohol related liver disease, metabolic dysfunction associated fatty liver disease and viral hepatitis, for selected cases of hepatocellular carcinoma, for acute liver failure and for some metabolic and genetic diseases. The American surgeon Thomas Starzl performed the first human liver transplant in 1963, and the first long term survivor followed in 1967. For liver cancer, the Milan criteria, which limit the size and number of tumors, have been widely used to select patients with good expected outcomes. In many countries, allocation of deceased donor livers is prioritized using the MELD score, which estimates the risk of death from liver disease based on blood tests. Living donor liver transplantation, in which a healthy person donates part of their liver, is particularly common in Asia, where deceased donation is less available, and relies on the ability of the liver to regenerate in both donor and recipient. Split liver transplantation divides one donor liver between two recipients. The operation involves removing the diseased liver and connecting the hepatic veins or vena cava, portal vein, hepatic artery and bile duct; the piggyback technique preserves the recipient vena cava. Complications include early graft dysfunction, hepatic artery thrombosis, bile duct leaks and strictures, rejection and infection. Lifelong immunosuppression is required, and most recipients survive for many years after transplantation.