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Long term outcome of liver transplantation for viral hepatitis: is there a need to re-evaluate patient selection?
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Article |
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Until recently, a transplant unit's success
was measured by its one year recipient survival
figure. Early results were poor, but transplantation has evolved
during the 1980s and 1990s into a routine treatment for which one year
recipient survival approaches 90%. Developments responsible for
improved recipient outcome include the refinement of patient selection
criteria, advances in surgery, anaesthesia and intensive care, and
refinement of immunosuppressive protocols. As the results of
transplantation improved, indications for transplantation expanded and
contraindications were relaxed. The inevitable consequence of success
has been a consistent expansion of the recipient population.
Unfortunate for the potential recipient, however, has been the failure
of the organ donor pool to expand at the same rate. Of course, the
relative shortage of suitable organ donors need not affect the results
of transplantation, but is reflected by a growing number of waiting
list deaths. Though the outcome of
transplanted patients still provides one
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