[A note form chair person: International Symposium on transplantation]

Orthotopic liver transplantation is now a widely accepted surgical modality for end-stage liver disease, although the shortage of grafts has remained a serious medical and social problem. This has led to the development of new approaches such as split liver transplantation and living related-donor liver transplantation, which have not completely resolved the problem. It is expected that future techniques will rely on better and less toxic agents for preventing rejection, xenotransplantation, and "organ engineering" methods based on tissue engineering techniques. More research is required before xenotransplantation is established clinically due to the current lack of knowledge of physiology, immunology, and infection risks. The mechanism of hyperacute rejection has been the subject of intensive investigation and is gradually being clarified. However, the detailed mechanisms of delayed xengraft rejection and cell-mediated immune response are still poorly understood. Improvement of cell culture conditions in tissue engineering may permit the generation of human organs as substitutes for grafts in the transplantation setting.