Indications for orthotopic liver transplantation: with particular reference to hepatomas, biliary atresia, cirrhosis, Wilson's disease and serum hepatitis.

Abstract

Hepatic transplantation has passed through the feasibility stage of development since survival of humans for as long as 2½ years has been achieved following removal of the liver and its replacement (orthotopic transplantation) with a cadaveric homograft. Consequently, the position will be taken that liver transplantation is a legitimate albeit imperfect form of treatment. With this attitude, there is not a question about the propriety of clinical hepatic transplantation but only about the circumstances under which it should be considered. The opinions to be developed will be based primarily upon our own experience with orthotopic transplantation,1 although the reader is also referred to the important observations of Calne,2 Fortner et al.,3 and Birtch and Moore.4