Liver transplantation provides the only chance of survival for a person whose liver has been destroyed by disease or injury. The liver is vital for life because it is responsible for:
- Storing body fuels and vitamins
- Synthesizing blood-clotting factors
- Managing the products of normal red blood cell breakdown and their conversion to the valuable substance bile
- Regulating the quantity of bile produced
- Changing poisonous nitrogenous body waste products to the less toxic urea that can safely be excreted in the urine
- Changing other toxic substances found naturally in the body to safer, less toxic forms so that detoxified poisons are then excreted
liver transplant represents a comparatively new development. The first successful transplant was performed in 1967, but the operation has been widely accepted only since about 1983.
The liver is technically more difficult to transplant than the kidney and, although (in adults) the success rate is not as high, results are steadily improving. Safer methods of preventing tissue rejection by the immune system, better solutions for the preservation of the donor organ, new surgical procedures, and more effective selection of suitable recipients have all contributed to this record of increased success.
Surgery is designed to provide the patient with a new, functioning liver so that the body may return to a state of comparative normality. The liver donor may be someone recently deceased through accident or, since the beginning of this decade, may be a living close relative who donates a segment of his or her liver.
Because the liver has excellent regenerative faculties, a part of the liver, properly connected during transplantation, can increase in size to meet the needs of the recipient's body. In fact, some centers routinely split a donated liver among two patients.
In all forms of transplant surgery it is important that the donated organ be accepted by the patient's body. Tissue from a close relative is less likely to be rejected by the recipient's immune system than is tissue from an unrelated donor.