Human liver transplantation: analysis of data on 540 patients from four centers

The results of liver transplantation in a total of 540 patients from four centers in the United States and Western Europe have been collated. Twenty-five per cent of all transplants were performed for neoplastic disease. One- and 3-year survivals for this group were approximately 26 and 12% overall, and survival differed little for patients transplanted before and after January 1, 1980. Among the 44% of patients transplanted for endstage cirrhosis, 3-year survival was lowest for patients with alcoholic cirrhosis (20%). Three-year survival was greater for patients with nonalcoholic cirrhosis (29% overall), did not differ markedly among the various subtypes, and was greater for patients transplanted after January 1, 1980 (42%), as compared with before (22%). Patients with biliary atresia, sclerosing cholangitis, and metabolic and miscellaneous disorders constituted the remaining 30% of patients; 3-year survival varied from about 20 to 44% overall for the various subgroups, with a consistent trend toward improved survival among patients transplanted after January 1, 1980. The use of cyclosporin may not wholly explain this improved survival among more recently transplanted patients. Quality of life for transplant recipients surviving at least 3 months, as judged by a limited amount of data regarding time-in-hospital and functional status, appears to be good.