The first human liver transplant was performed in the United States in 1963. During the 1960s and 1970s the technique was developed, but less than half of recipients lived beyond one year.
With the advent of immunosuppressive drugs such as cyclosporin, results improved dramatically so that an 80 per cent one-year patient survival rate is now the norm.
Liver transplantation is carried out for irreversible liver failure. Patients with alcoholic liver disease account for about 75 per cent of those with liver failure.
A liver is removed from the brain-dead donor, having been first flushed out with a preservative solution. It is transported in ice. The recipient's liver is then removed and part or all of the donor liver is put in its place in a lengthy and highly complex procedure. Large blood vessels must be reconnected and the bile ducts of the donor and recipient connected up.
In the post-operative period high doses of steroids and immunosuppressant drugs are administered to the patient to minimise the risk of rejection.
There are many potential complications of liver transplantation. The most serious is that the new liver does not function. However, initial poor function often improves after several days. Blood vessels can become blocked by clots and the bile ducts may leak or obstruct. And, like any other patient undergoing major surgery, post-operative infection is a risk.
The better the overall medical condition of the transplant recipient, the better the outcome. The longest living liver transplant patient has survived for over 26 years following the operation.