Liver Transplantation: Indications and Selection of Candidates and Immediate Complications

Liver transplantation is the only established therapy for patients with end-stage liver disease. The procedure is also indicated in fulminant liver failure, metabolic diseases, and hepatocellular carcinoma. Survival after liver transplantation is approximately 75-80% at 3 years. Donor organ shortage is a major limitation in adult liver transplantation and is responsible for significant mortality and morbidity in patients on the waiting list. Strategies to increase the number of donor organs include the use of marginal livers, split liver, and living donors. Life-long immunosuppression is required in these patients. Post-transplant complications include rejection, recurrent disease, opportunistic infections, and lymphoproliferative disorders, in addition to the risk of extrahepatic malignancy.