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The first 100 liver transplants at UCLA.

R W Busuttil¹, J O Colonna, J R Hiatt

¹Department of Surgery, UCLA School of Medicine.

Annals of Surgery

|October 1, 1987

Summary

The UCLA liver transplant program

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Area of Science:

Hepatology
Transplant Surgery
Immunology

Background:

UCLA initiated a clinical liver transplantation program in 1984, following extensive laboratory research.
This study details the outcomes of the first 100 orthotopic liver transplants (OLT) performed between February 1984 and November 1986.

Purpose of the Study:

To evaluate the early clinical outcomes and challenges of a new liver transplantation program.
To analyze patient survival rates, complication profiles, and predictors of mortality in the initial cohort.

Main Methods:

Performed 100 OLTs in 83 patients (43 adults, 40 children) using standard surgical techniques.
Matched donors and recipients primarily by size and ABO compatibility; 28 OLTs were performed across blood groups.
Employed a cyclosporine-steroid immunosuppressive regimen, supplemented with OKT3 for refractory rejection.

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Main Results:

Overall patient survival was 76% (63/83), with 1- and 2-year actuarial survival rates at 73%.
Common complications included pulmonary (78%), infectious (51%), and renal (25%). All patients experienced acute rejection.
Postoperative dialysis and severe rejection were significant predictors of early mortality.

Conclusions:

Liver transplantation offers a significant therapeutic option for patients with end-stage liver disease.
The early experience highlights the complexity of the procedure, including high complication rates and the need for intensive management.
Despite challenges, the program demonstrated promising survival rates and functional recovery in adult and pediatric recipients.