The Scottish Liver Transplant Unit: current and future perspectives.

Area of Science:

• Hepatology
• Transplant Surgery
• Organ Donation

Background:

• The Scottish Liver Transplant Unit (SLTU) has performed over 900 liver transplants since 1992.
• Significant advancements in organ donation and transplantation have occurred over two decades.
• Scotland faces a critical shortage of organ donors, coupled with a rising incidence of cirrhosis.

Purpose of the Study:

• To review the evolution of surgical aspects in liver transplantation over the past 20 years.
• To highlight innovations driven by limited organ supply and waiting list mortality.
• To discuss strategies for improving organ donation and optimizing graft utilization.

Main Methods:

• Review of surgical techniques and advancements in liver transplantation.
• Analysis of changes in organ donation and transplantation practices.
• Examination of innovations such as marginal grafts, DCD (donated after cardiac death) organs, split-liver transplants, and living-donor liver transplantation.

Main Results:

• Liver transplantation is constrained by limited organ availability, particularly in Scotland.
• Innovations have been implemented to address organ scarcity, including the use of marginal grafts and split livers.
• Living-donor liver transplantation has emerged as a viable option.

Conclusions:

• Urgent need to increase organ donation rates in Scotland.
• Ongoing research into novel treatments and cell therapy to optimize marginal graft outcomes.
• SLTU continues to provide advanced liver transplant care amidst rising demand.