[Surgical hepatology: liver transplantation and extensive resections]

During 7 years (from 1990 until now) the only in Russia program of transplantation of the liver is under way in RCS RAMS. Up to now the experience has been accumulated of 24 transplantations in 23 patients, including 1 retransplantation and 6 transplantations from alive relative donor. Indications for the operation were incurable diseases of the liver with fatal prognosis including unresectable primary focal diseases. Long-term survival of the recipients in the last followed up series was obtained in 80% of cases. The longest survival reached 7 years. The quality of life of the recipients is quite satisfactory, 2 patients gave birth to healthy children. At the same time at the background of extreme deficiency of donor organs mortality rate of potential recipients during "waiting" period made up to 60.4%. Parallel development of resectional surgery of the liver made it possible to perform 49 extensive and maximally spacious resections with good results (early postoperative lethality--4.1%, actuarial 5 year survival rate of these patients--64%). Accumulated experience was a basement for the development of program for transplantation of a fragment of the liver from living relative donor.