ACTA.FAC.MED.NAISS. 1998; 15(1), 59-64

TRANSPLANTATION OF THE LIVER
Tomislav Tasiæ

Organ transplantation has become a successful method of treatment for the patients with terminal insufficiency of vital organs. There are many centres that perform liver transplantation, in our country being the Institute for Cardiovascular Diseases "Dedinje" in Belgrade. Fundamental conditions to be fulfilled for a successful liver transplantation are:1) an apropriate selection of patients/candidates, and 2) a timely surgical intervention. Main indications are: terminal stage of a chronic liver disease (cholestatic, hepatocellular or vascular disease), fulminant liver insufficiency (viral hepatitis, toxins, Wilson's disease), hereditary metabolic disorders (primary hyperoxaluria type l, familial hypercholesterolemy), liver neoplasm (primary liver cancer), liver trauma, failure of the liver transplant. Absolute contraindications for liver transplantation are: cardiopulmonary insufficiency (Pa02 below 55 mm Hg), disseminated active insufficiency, hereditary immune deficit or acquired immunodeficiency and HIV infection, disseminated malignancy, active alcoholism and extrahepatic manifestations of alcoholic damages (CNS), severe psychiatric conditions refractory to therapy, irreversible brain damages and brain oedema. Posttransplantation survival is, on the average, 65% after 1 year, and 50% after 4 years. Large numbers of liver transplantation performed worldwide, postoperative follow-up, and statistical data processing should give a more accurate insight into the survival characteristics of patients subjected to liver transplantation.

Key words: Transplantation liver