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Related Experiment Videos

One thousand liver transplants. The lessons learned

R W Busuttil1, A Shaked, J M Millis

  • 1Dumont-UCLA Transplant Center, Department of Surgery.

Annals of Surgery
|May 1, 1994
PubMed
Summary

Liver transplant outcomes have significantly improved due to expanded donor acceptance and broader recipient criteria. This study shows better survival rates and resource utilization in recent liver transplant procedures.

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Area of Science:

  • Hepatology
  • Transplant Surgery
  • Medical Outcomes Research

Background:

  • Liver transplantation has advanced significantly since its inception.
  • Progress in the 1980s included improved organ preservation, surgical standardization, immunosuppression, and patient selection.

Purpose of the Study:

  • To evaluate the first 1000 liver transplants at UCLA Medical Center.
  • To identify factors contributing to improved liver transplant outcomes.

Main Methods:

  • Comparative analysis of the first 100 liver transplants (1984-1986) versus the subsequent 200 (1991-1992).
  • Assessment of donor utilization, recipient criteria evolution, patient care, morbidity, mortality, survival, and resource use.

Main Results:

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  • Reduced donor refusal rates (31% to 4%) and increased acceptance of alcoholic and high-risk recipients (UNOS criteria 4).
  • Significant improvements in operative time, blood product usage, ICU stay, and overall hospital stay.
  • One-year patient survival improved from 73% to 88%.

Conclusions:

  • Organs with unfavorable characteristics can be successfully transplanted.
  • Older and high-risk patients are now routinely transplanted with good outcomes.
  • Liberalized donor and recipient criteria have led to improved survival, optimized resource use, and cost reduction in liver transplantation.