Liver transplantation: who to refer and when

Liver transplantation is a surgical procedure offered to individuals with irreversible, near fatal liver disease. The timing of both transplantation listing and surgical engraftment are critical factors in the success of this endeavour. To accomplish each and maintain surgical survival rates without prematurely transplanting individuals to achieve excellent outcome statistics is an art that requires knowledge about the procedure and the natural history of the specific liver disease in question. Herein are the views of the transplant team at Loyola University of Chicago as to how this can be accomplished within the framework of the American experience, and the rules and regulations governing donor organ procurement and allocation in the United States.