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Liver Transplantation: Historical Perspective

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Anesthesia and Perioperative Care for Organ Transplantation

Abstract

Liver transplantation has undergone a remarkable evolution in the past five decades since it was explored by a few inspiring pioneers who dreamed and believed that the replacement of the diseased liver was exactly what was needed for patients with end-stage liver disease (ESLD). Clinical outcome was not satisfactory during the experimental stage (1963–1981) due to inadequately preserved cadaveric organs, coagulopathy including fibrinolysis and excessive activation of coagulation, and difficulty in maintaining the balance between immunosuppression and infection control. It was accepted as a clinical therapy during the developmental stage (1982–1988) with the improved surgical technique using venovenous bypass and application of clinical research results in patient care. During the maturation stage (1989–2000), various types of liver transplantation was performed including xenotransplantation and living-donor liver transplantation, and anesthesiologists were able to care medically challenging patients. In the proliferation stage (2001–present), liver transplantation centers are developed in most medical centers as liver transplantation became manageable with 1-year survival of up to 90 %. This evolution was made possible by the joint effort of dedicated physicians, scientists, and health care workers of diverse medical fields. International Liver Transplantation Society has been another contributor for this successful endeavor.

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Kang, Y. (2017). Liver Transplantation: Historical Perspective. In: Subramaniam, K., Sakai, T. (eds) Anesthesia and Perioperative Care for Organ Transplantation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6377-5_25

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