Abstract:

During the past 30 years orthotopic liver transplantation (OL~X)h.as become a hIghly successful form of therapy, and as of this writing it is being performed at more than 100institutions in the U.S., and a similar number in Europe. This is testimony to the great advances achieved in this field since the 1960sand 1970s,when there were essentially only two places actively engaged in liver transplantation. Essential to its success have been the technical refinements introduced during the last three decades,7,9 which have allowed many surgeons around the world to be able to do the procedure safely. Liver transplantation is still considered as one of the most complex operations, and therefore the margin of error is small and attention to technical detail is crucial to a satisfactory outcome. This is magnified in importance since OLTx, unlike kidney, heart, pancreas and intestinal transplantation, lacks a back-up system, such as dialysis, ventricular assist device, insulin or total parenteral nutrition. Thus, the smallest mistake in the surgical management of the patient may prove fatal.

Authors:

Ignazio Roberto Marino, M.D., Howard R. Doyle, M.D., Kareem Abu-Elmagd, M.D., Carlo L. Scotti-Foglieni, M.D., Rafael Mañez, M.D., Andreas G. Tzakis, M.D., Saturo Todo, M.D., John J. Fung, M.D., Ph.D., Thomas E. Starzi, M.D., Ph.D., Pittsburgh Transplantation Institute, University of Pittsburgh Medical Center School of Medicine, Pittsburgh, PA

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