Assessment of liver transplantation

Liver transplantation, one of the most technically difficult of all solid organ transplant, is effective in extending the lives of carefully selected adult patients who have end-stage organ failure due to irreversibly damaged livers. Factors that influence the outcome of liver transplantation include the specific liver disease, patient's health status, and the presence or absence of extrahepatic disease or disorder. The outcome of liver transplantation has been improved significantly by the introduction of cyclosporine and continues to be improved by the use of newer immunosuppressants such as OKT3 monoclonal antibody and antithymocyte globulin for the prevention of graft rejection. The quality of life for those who survive one or more years was generally good. Survival rates were good for patients with primary biliary cirrhosis, primary sclerosing cholangitis, hepatitis B (antigen negative), alcoholic cirrhosis, alpha-1-antitrypsin deficiency disease, Wilson's disease, and primary hemochromatosis. Patients with liver malignancies, with the possible exception of those with epithelioid hemangioendoepithelioma, had poor outcomes, while patients presenting with other end-stage liver diseases had variable outcomes.