Liver transplantation

Since the first successful human liver transplant performed in 1967 by Thomas Starzl in Denver, Colorado, the field of liver transplantation has undergone significant advances. The most significant changes have been in the refinement of techniques that allow for the reduction in size of an adult liver to accommodate for the smaller size or organ needed in infants and children. This allows for the more timely transplantation of the child waiting for an organ, and has decreased the number of children who die without receiving a liver. Improved immunosuppression with calcineurin inhibitors (CI), such as cyclosporine and more recently, tacrolimus, have improved the long-term survival of transplanted organs. More effective antiviral and antibacterial medications, as well as improved detection techniques for post-transplant lymphoproliferative disease have also contributed to the improved survival. Lastly, more refined techniques of organ procurement, preservation, and implantation, as well as better peri-and postoperative care have all contributed to improve outcomes over the past four decades.