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World J Gastroenterol. May 14, 2014; 20(18): 5363-5374
Published online May 14, 2014. doi: 10.3748/wjg.v20.i18.5363
Liver transplantation: Fifty years of experience
Alice Tung Wan Song, Vivian Iida Avelino-Silva, Rafael Antonio Arruda Pecora, Vincenzo Pugliese, Luiz Augusto Carneiro D’Albuquerque, Edson Abdala
Alice Tung Wan Song, Rafael Antonio Arruda Pecora, Vincenzo Pugliese, Luiz Augusto Carneiro D’Albuquerque, Edson Abdala, Liver and Digestive Organ Transplantation Unit, Gastroenterology Department, University of Sao Paulo Medical School, Sao Paulo 05403-900, Brazil
Alice Tung Wan Song, Vivian Iida Avelino-Silva, Infectious Diseases Department, University of Sao Paulo Medical School, Sao Paulo 05403-900, Brazil
Alice Tung Wan Song, Edson Abdala, Hepatitis Research Laboratory, Infectious Diseases Department, University of Sao Paulo Medical School, Sao Paulo 05403-000, Brazil
Author contributions: Avelino-Silva VI, Song ATW, Pecora RAA, Pugliese V, D’Albuquerque LAC and Abdala E performed the literature review, wrote the paper, drafted the article and approved the final version to be published.
Correspondence to: Alice Tung Wan Song, MD, PhD, Liver and Digestive Organ Transplantation Unit, Gastroenterology Department, University of São Paulo Medical School, São Paulo 05403-900, Brazil. alicetwsong@gmail.com
Telephone: +55-11-26613323 Fax: +55-11-26613323
Received: September 29, 2013
Revised: January 19, 2014
Accepted: February 26, 2014
Published online: May 14, 2014
Abstract

Since 1963, when the first human liver transplantation (LT) was performed by Thomas Starzl, the world has witnessed 50 years of development in surgical techniques, immunosuppression, organ allocation, donor selection, and the indications and contraindications for LT. This has led to the mainstream, well-established procedure that has saved innumerable lives worldwide. Today, there are hundreds of liver transplant centres in over 80 countries. This review aims to describe the main aspects of LT regarding the progressive changes that have occurred over the years. We herein review historical aspects since the first experimental studies and the first attempts at human transplantation. We also provide an overview of immunosuppressive agents and their potential side effects, the evolution of the indications and contraindications of LT, the evolution of survival according to different time periods, and the evolution of methods of organ allocation.

Keywords: Liver transplantation, History, Survival, Indications, Organ allocation

Core tip: Liver transplantation is currently considered a life-saving procedure. Over the past 50 years, the world has witnessed evolving strategies in surgical techniques, immunosuppressive drugs, intensive pre- and post-operative care, and, the prevention of disease recurrence and has discussed policies of organ allocation. This review highlights some of these aspects regarding their historical evolution over the past 50 years.