The Many Facets of Liver Transplantation

Liver transplantion is the most effective treatment for end-stage liver diseases and certain liver cancers. Since the first liver transplantation performed by Thomas Starzl in 1963, significant advances have been made. Technically, the transplant procedure has been simplified and standardized. Building on the knowledge gained in liver regeneration and portal flow management, innovative techniques such as auxiliary liver transplantation, split-liver grafts, and two-stage transplantation have been developed, broadening access to liver transplants for previously ineligible patients. Immunologically, liver transplantation has improved our understanding of the host-graft relationship, dispelled the taboo against transplanting cancers, and demonstrated microchimerism, a vector for potential spontaneous graft tolerance. Ultimately, there is not "one" but "several" forms of liver transplantation.