Liver transplantation: the current situation

Abstract

Over the years, an improving liver transplant (LT) survival rate (1- and 5-year survival of 83% and 75%, respectively) has been instrumental in establishing transplant surgery as a durable therapy for all forms of end-stage liver disease and for some malignant conditions. The success of such treatment has resulted in a progressively increasing demand for liver transplantation. However, at the same time the availability of donor organs has diminished, resulting in the number of potential recipients for liver transplantation exceeding organ supply. Several strategies have been explored with the aim to increase access to liver transplantation, including: obtaining organs from non-heart-beating donors and live donors, and splitting and using livers from expanded donor criteria. This article discusses the utility of the mentioned techniques along with other strategies (e.g., Model for End-Stage Liver Disease [MELD] score), as well as the evolution of indications, contraindications, and postoperative care.