Present Status of Liver Transplantation


0008 The concept of liver replacement was apparently first envisioned by Cannon 0009 [1] of Los Angeles,who performed liver replacements in animals without surviv0010 al. His report was so brief that it did not have a title and did not even stipulate 0011 the animals used. The first detailed report of liver transplantation was by C. 0012 Stewart Welch [2] of Albany, New York, who transplanted auxiliary organs 0013 into the pelvis or right paravertebral gutter of dogs. 0014 The technical requirements of liver replacement and the behavior of dogs 0015 submitted to this operation without immunosuppressive therapy were worked • 0016 out by ourselves [3, 4] and by the team headed by Francis D. Moore at the 0017 Peter Bent Brigham Hospital in Boston [5]. The first chronic survivors after 0018 liver replacement in experimental animals were obtained in 1963 and reported 0019 in' 1965 [6]. These animals were treated with azathioprine alone, which could 0020 often be stopped after only 3 or 4 months with prolonged subsequent good 0021 health of the recipients <ilf mongrel nonrelated livers [7]. 0022 The first clinical liver transplantations were performed in early 1963 [8]. 0023 From this time until mid-1967 six attempts were made by us, all leading to 0024 the death of the recipients within a few days or weeks. The first extended 0025 survival after liver replacement in humans was achieved in the summer of 1967. 0026 Our ~experience with the first 25 cases of liver replacement was summarized 0027 in a book published in 1969 [7]. Including the first unsuccessful attempts, we had compiled 111 cases of orthotopic liver transplantation by the spring of 1976. Thirty-one of these 111 patients lived for at least one postoperative year and from that original group the longest current survivor is now more than 12 years. It became apparent during this time [9] that many general aspects of care could be improved including the technical details of the operation, diagnostic procedures during the postoperative period (which were designed to identify causes other than rejection for postoperative hepatic failure), and immunosuppression. The basis for liver transplantation was strengthened by the introduction of modifications to alleviate these sources of tragedy. The modifications included refined anatomical studies of the structures which had to be dealt with, increased application of

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@inproceedings{Starzl2010PresentSO, title={Present Status of Liver Transplantation}, author={T . E . Starzl and Shunzaburo Iwatsuki and Byers W . Shaw}, year={2010} }