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id="toc-Biliary_complications" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Biliary_complications"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Biliary complications</span> </div> </a> <ul id="toc-Biliary_complications-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Vascular_complications" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Vascular_complications"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3</span> <span>Vascular complications</span> </div> </a> <ul id="toc-Vascular_complications-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Technique" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Technique"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Technique</span> </div> </a> <button aria-controls="toc-Technique-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Technique subsection</span> </button> <ul id="toc-Technique-sublist" class="vector-toc-list"> <li id="toc-Cooling" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Cooling"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Cooling</span> </div> </a> <ul id="toc-Cooling-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Living_donor_transplantation" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Living_donor_transplantation"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>Living donor transplantation</span> </div> </a> <ul id="toc-Living_donor_transplantation-sublist" class="vector-toc-list"> <li id="toc-Donor_requirements" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Donor_requirements"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2.1</span> <span>Donor requirements</span> </div> </a> <ul id="toc-Donor_requirements-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Complications" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Complications"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2.2</span> <span>Complications</span> </div> </a> <ul id="toc-Complications-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Pediatric_transplantation" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Pediatric_transplantation"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2.3</span> <span>Pediatric transplantation</span> </div> </a> <ul id="toc-Pediatric_transplantation-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Benefits" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Benefits"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2.4</span> <span>Benefits</span> </div> </a> <ul id="toc-Benefits-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Screening_for_donors" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Screening_for_donors"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2.5</span> <span>Screening for donors</span> </div> </a> <ul id="toc-Screening_for_donors-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Post-transplant_immunosuppression" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Post-transplant_immunosuppression"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.3</span> <span>Post-transplant immunosuppression</span> </div> </a> <ul id="toc-Post-transplant_immunosuppression-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Recovery_and_outcomes" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Recovery_and_outcomes"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Recovery and outcomes</span> </div> </a> <ul id="toc-Recovery_and_outcomes-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Society_and_culture" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Society_and_culture"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Society and culture</span> </div> </a> <button aria-controls="toc-Society_and_culture-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Society and culture subsection</span> </button> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> <li id="toc-Famous_liver_transplant_recipients" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Famous_liver_transplant_recipients"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.1</span> <span>Famous liver transplant recipients</span> </div> </a> <ul id="toc-Famous_liver_transplant_recipients-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Research_directions" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Research_directions"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Research directions</span> </div> </a> <button aria-controls="toc-Research_directions-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Research directions subsection</span> </button> <ul id="toc-Research_directions-sublist" class="vector-toc-list"> <li id="toc-Cooling_2" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Cooling_2"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.1</span> <span>Cooling</span> </div> </a> <ul id="toc-Cooling_2-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Normothermic_Regional_Perfusion" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Normothermic_Regional_Perfusion"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.2</span> <span>Normothermic Regional Perfusion</span> </div> </a> <ul id="toc-Normothermic_Regional_Perfusion-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Herpesvirus_6_Reactivation" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Herpesvirus_6_Reactivation"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.3</span> <span>Herpesvirus 6 Reactivation</span> </div> </a> <ul id="toc-Herpesvirus_6_Reactivation-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Special_populations" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Special_populations"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>Special populations</span> </div> </a> <button aria-controls="toc-Special_populations-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Special populations subsection</span> </button> <ul id="toc-Special_populations-sublist" class="vector-toc-list"> <li id="toc-Alcohol_dependence" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Alcohol_dependence"> <div class="vector-toc-text"> <span class="vector-toc-numb">9.1</span> <span>Alcohol dependence</span> </div> </a> <ul id="toc-Alcohol_dependence-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-HIV" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#HIV"> <div class="vector-toc-text"> <span class="vector-toc-numb">9.2</span> <span>HIV</span> </div> </a> <ul id="toc-HIV-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Medical_cannabis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Medical_cannabis"> <div class="vector-toc-text"> <span class="vector-toc-numb">9.3</span> <span>Medical cannabis</span> </div> </a> <ul id="toc-Medical_cannabis-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">12</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Liver transplantation</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 27 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-27" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">27 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%B2%D8%B1%D8%A7%D8%B9%D8%A9_%D8%A7%D9%84%D9%83%D8%A8%D8%AF" title="زراعة الكبد – Arabic" lang="ar" hreflang="ar" data-title="زراعة الكبد" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Qaraciy%C9%99r_transplantasiyas%C4%B1" title="Qaraciyər transplantasiyası – Azerbaijani" lang="az" hreflang="az" data-title="Qaraciyər transplantasiyası" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%A7%D0%B5%D1%80%D0%BD%D0%BE%D0%B4%D1%80%D0%BE%D0%B1%D0%BD%D0%B0_%D1%82%D1%80%D0%B0%D0%BD%D1%81%D0%BF%D0%BB%D0%B0%D0%BD%D1%82%D0%B0%D1%86%D0%B8%D1%8F" title="Чернодробна трансплантация – Bulgarian" lang="bg" hreflang="bg" data-title="Чернодробна трансплантация" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Trasplantament_de_fetge" title="Trasplantament de fetge – Catalan" lang="ca" hreflang="ca" data-title="Trasplantament de fetge" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Transplantace_jater" title="Transplantace jater – Czech" lang="cs" hreflang="cs" data-title="Transplantace jater" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Lebertransplantation" title="Lebertransplantation – German" lang="de" hreflang="de" data-title="Lebertransplantation" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Trasplante_de_h%C3%ADgado" title="Trasplante de hígado – Spanish" lang="es" hreflang="es" data-title="Trasplante de hígado" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%BE%DB%8C%D9%88%D9%86%D8%AF_%DA%A9%D8%A8%D8%AF" title="پیوند کبد – Persian" lang="fa" hreflang="fa" data-title="پیوند کبد" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Transplantation_h%C3%A9patique" title="Transplantation hépatique – French" lang="fr" hreflang="fr" data-title="Transplantation hépatique" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EA%B0%84%EC%9D%B4%EC%8B%9D" title="간이식 – Korean" lang="ko" hreflang="ko" data-title="간이식" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Trapianto_di_fegato" title="Trapianto di fegato – Italian" lang="it" hreflang="it" data-title="Trapianto di fegato" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%94%D7%A9%D7%AA%D7%9C%D7%AA_%D7%9B%D7%91%D7%93" title="השתלת כבד – Hebrew" lang="he" hreflang="he" data-title="השתלת כבד" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%95%E0%B4%B0%E0%B5%BE_%E0%B4%AE%E0%B4%BE%E0%B4%B1%E0%B5%8D%E0%B4%B1%E0%B4%BF%E0%B4%B5%E0%B4%AF%E0%B5%8D%E0%B4%95%E0%B5%8D%E0%B4%95%E0%B5%BD" title="കരൾ മാറ്റിവയ്ക്കൽ – Malayalam" lang="ml" hreflang="ml" data-title="കരൾ മാറ്റിവയ്ക്കൽ" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Levertransplantatie" title="Levertransplantatie – Dutch" lang="nl" hreflang="nl" data-title="Levertransplantatie" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E8%82%9D%E7%A7%BB%E6%A4%8D" title="肝移植 – Japanese" lang="ja" hreflang="ja" data-title="肝移植" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Jigar_transplantatsiyasi" title="Jigar transplantatsiyasi – Uzbek" lang="uz" hreflang="uz" data-title="Jigar transplantatsiyasi" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Przeszczepienie_w%C4%85troby" title="Przeszczepienie wątroby – Polish" lang="pl" hreflang="pl" data-title="Przeszczepienie wątroby" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Transplante_de_f%C3%ADgado" title="Transplante de fígado – Portuguese" lang="pt" hreflang="pt" data-title="Transplante de fígado" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%A2%D1%80%D0%B0%D0%BD%D1%81%D0%BF%D0%BB%D0%B0%D0%BD%D1%82%D0%B0%D1%86%D0%B8%D1%8F_%D0%BF%D0%B5%D1%87%D0%B5%D0%BD%D0%B8" title="Трансплантация печени – Russian" lang="ru" hreflang="ru" data-title="Трансплантация печени" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-si mw-list-item"><a href="https://si.wikipedia.org/wiki/%E0%B6%85%E0%B6%9A%E0%B7%8A%E0%B6%B8%E0%B7%8F%E0%B7%80_%E0%B6%B6%E0%B6%AF%E0%B7%8A%E0%B6%B0_%E0%B6%9A%E0%B7%92%E0%B6%BB%E0%B7%93%E0%B6%B8" title="අක්මාව බද්ධ කිරීම – Sinhala" lang="si" hreflang="si" data-title="අක්මාව බද්ධ කිරීම" data-language-autonym="සිංහල" data-language-local-name="Sinhala" class="interlanguage-link-target"><span>සිංහල</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Presaditev_jeter" title="Presaditev jeter – Slovenian" lang="sl" hreflang="sl" data-title="Presaditev jeter" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%A2%D1%80%D0%B0%D0%BD%D1%81%D0%BF%D0%BB%D0%B0%D0%BD%D1%82%D0%B0%D1%86%D0%B8%D1%98%D0%B0_%D1%98%D0%B5%D1%82%D1%80%D0%B5" title="Трансплантација јетре – Serbian" lang="sr" hreflang="sr" data-title="Трансплантација јетре" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a 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.infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Liver transplantation</th></tr><tr><td colspan="2" class="infobox-image"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Human_Hepar.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6f/Human_Hepar.jpg/280px-Human_Hepar.jpg" decoding="async" width="280" height="210" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6f/Human_Hepar.jpg/420px-Human_Hepar.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6f/Human_Hepar.jpg/560px-Human_Hepar.jpg 2x" data-file-width="1600" data-file-height="1200" /></a></span><div class="infobox-caption">A healthy human liver removed at autopsy</div></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Hepatology" title="Hepatology">Hepatology</a>, <a href="/wiki/Transplant_surgery" class="mw-redirect" title="Transplant surgery">transplant surgery</a></td></tr><tr><th scope="row" class="infobox-label">Complications</th><td class="infobox-data">Primary nonfunction of graft, <a href="/wiki/Hepatic_artery_thrombosis" title="Hepatic artery thrombosis">hepatic artery thrombosis</a>,<sup id="cite_ref-Piardi_1-0" class="reference"><a href="#cite_note-Piardi-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Portal_vein_thrombosis" title="Portal vein thrombosis">portal vein thrombosis</a>,<sup id="cite_ref-Piardi_1-1" class="reference"><a href="#cite_note-Piardi-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> biliary stenosis, biliary leak, ischemic cholangiopathy<sup id="cite_ref-Memeo_2-0" class="reference"><a href="#cite_note-Memeo-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/ICD-9-CM_Volume_3" title="ICD-9-CM Volume 3">ICD-9-CM</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="http://icd9cm.chrisendres.com/index.php?srchtype=procs&srchtext=50.5&Submit=Search&action=search">50.5</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D016031">D016031</a></span></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="https://medlineplus.gov/ency/article/003006.htm">003006</a></span></td></tr><tr class="noprint"><td colspan="2" class="infobox-full-data"><div style="text-align: right;">[<a href="https://www.wikidata.org/wiki/Q1368191" class="extiw" title="d:Q1368191">edit on Wikidata</a>]</div></td></tr></tbody></table> <p><b>Liver transplantation</b> or <b>hepatic transplantation</b> is the replacement of a <a href="/wiki/Liver_disease" title="Liver disease">diseased liver</a> with the healthy <a href="/wiki/Liver" title="Liver">liver</a> from another person (<a href="/wiki/Allograft" class="mw-redirect" title="Allograft">allograft</a>). Liver transplantation is a treatment option for <a href="/wiki/Cirrhosis" title="Cirrhosis">end-stage liver disease</a> and <a href="/wiki/Acute_liver_failure" title="Acute liver failure">acute liver failure</a>, although availability of donor organs is a major limitation. Liver transplantation is highly regulated, and only performed at designated transplant medical centers by highly trained transplant physicians. Favorable outcomes require careful screening for eligible recipients, as well as a well-calibrated live or deceased donor match.<sup id="cite_ref-Reddy_2013_3-0" class="reference"><a href="#cite_note-Reddy_2013-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Medical_uses">Medical uses</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=1" title="Edit section: Medical uses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Liver transplantation is a potential treatment for acute or chronic conditions which cause irreversible and severe ("end-stage") liver dysfunction.<sup id="cite_ref-Varma_4-0" class="reference"><a href="#cite_note-Varma-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Since the procedure carries relatively high risks, is resource-intensive, and requires major life modifications after surgery, it is reserved for dire circumstances.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2022)">citation needed</span></a></i>]</sup> </p><p>Judging the appropriateness/effectiveness of liver transplant on case-by-case basis is critically important (<i>see <a href="#Contraindications">Contraindications</a></i>), as outcomes are highly variable.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2024)">citation needed</span></a></i>]</sup> </p><p>The Model for End Stage Liver Disease (<a href="/wiki/MELD_score" class="mw-redirect" title="MELD score">MELD score</a>) for adults and the Pediatric End Stage Liver Disease (PELD score) for children younger than 12 years old are clinical scoring tools that take various clinical criteria into consideration and are used to assess the need for a liver transplant.<sup id="cite_ref-Lucey_2023_5-0" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Higher scores for each clinical scoring tool indicates a higher severity of liver disease, and thus a greater need for a liver transplant.<sup id="cite_ref-Lucey_2023_5-1" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> In those with chronic liver disease, a decompensating event such as <a href="/wiki/Hepatic_encephalopathy" title="Hepatic encephalopathy">hepatic encephalopathy</a>, <a href="/wiki/Esophageal_varices" title="Esophageal varices">variceal bleeding</a>, <a href="/wiki/Ascites" title="Ascites">ascites</a>, or <a href="/wiki/Spontaneous_bacterial_peritonitis" title="Spontaneous bacterial peritonitis">spontaneous bacterial peritonitis</a> may also signal a new need for a liver transplant.<sup id="cite_ref-Lucey_2023_5-2" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Contraindications">Contraindications</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=2" title="Edit section: Contraindications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Although liver transplantation is the most effective treatment for many forms of end-stage liver disease, the tremendous limitation in allograft (donor) availability and widely variable post-surgical outcomes make case selection critically important. Assessment of a person's transplant eligibility is made by a multi-disciplinary team that includes surgeons, medical doctors, psychologists and other providers.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2022)">citation needed</span></a></i>]</sup> </p><p>The first step in evaluation is to determine whether the patient has irreversible liver-based disease which will be cured by getting a new liver.<sup id="cite_ref-Varma_4-1" class="reference"><a href="#cite_note-Varma-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Thus, those with diseases which are primarily based outside the liver or have spread beyond the liver are generally considered poor candidates. Some examples include: </p> <ul><li>someone with advanced liver cancer, with known/likely spread beyond the liver. Or those with cancer of any type, if the cancer cannot be treated successfully without rendering them unsuitable for transplant (other than skin cancers).<sup id="cite_ref-Lucey_2023_5-3" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li> <li>active illicit substance use<sup id="cite_ref-Lucey_2023_5-4" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li> <li>anatomic abnormalities that prevent liver transplantation<sup id="cite_ref-Lucey_2023_5-5" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li> <li>severe heart/lung disease, whether it is primary heart/lung disease, or brought on by the liver disease (unless the team thinks they can still proceed)<sup id="cite_ref-Lucey_2023_5-6" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/HIV/AIDS" title="HIV/AIDS">HIV/AIDS</a>, especially if it is not well-managed (some persons with HIV/AIDS that have very low or undetectable viral loads could still be eligible)<sup id="cite_ref-Lucey_2023_5-7" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li></ul> <p>Importantly, many contraindications to liver transplantation are considered reversible; a person initially deemed "transplant-ineligible" may later become a favorable candidate if the circumstances change.<sup id="cite_ref-Varma_4-2" class="reference"><a href="#cite_note-Varma-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Some examples include: </p> <ul><li>partial treatment of liver cancer, such that risk of spread beyond liver is decreased (for those with primary liver cancer or secondary spread to the liver, the medical team will likely rely heavily on the opinion of the patient's primary provider, the oncologist, and the radiologist)</li> <li>cessation of substance use (time period of abstinence is variable)</li> <li>improvement in heart function, e.g. by <a href="/wiki/Percutaneous_coronary_intervention" title="Percutaneous coronary intervention">percutaneous coronary intervention</a> or <a href="/wiki/Coronary_artery_bypass_surgery" title="Coronary artery bypass surgery">bypass surgery</a></li> <li>treated HIV infection (<i>see <a href="#Special_populations">Special populations</a></i>)</li></ul> <p>Other conditions, including hemodynamic instability requiring <a href="/wiki/Vasopressor" class="mw-redirect" title="Vasopressor">vasopressor</a> support, large liver cancers or those with invasion to blood vessels, intrahepatic <a href="/wiki/Cholangiocarcinoma" title="Cholangiocarcinoma">cholangiocarcinoma</a>, <a href="/wiki/Frailty_syndrome" title="Frailty syndrome">frailty</a>, fulminant liver failure with suspected brain injury, alcohol use disorder with recent alcohol consumption, cigarette smoking, inadequate social support, and nonadherence to medical management may disqualify someone from liver transplantation, however these cases are usually evaluated by the multi-disciplinary transplant team on an individual basis.<sup id="cite_ref-Lucey_2023_5-8" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Risks/complications"><span id="Risks.2Fcomplications"></span>Risks/complications</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=3" title="Edit section: Risks/complications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Graft_rejection">Graft rejection</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=4" title="Edit section: Graft rejection"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>After a liver transplantation, immune-mediated rejection (also known as <b>rejection</b>) of the allograft may happen at any time. Rejection may present with lab findings: elevated AST, ALT, GGT; abnormal liver function values such as prothrombin time, ammonia level, bilirubin level, albumin concentration; and abnormal blood glucose. Physical findings may include encephalopathy, jaundice, bruising and bleeding tendency. Other nonspecific presentation may include malaise, anorexia, muscle ache, low fever, slight increase in white blood count and graft-site tenderness.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2022)">citation needed</span></a></i>]</sup> </p><p>Three types of graft rejection may occur: hyperacute rejection, acute rejection, and chronic rejection. </p> <ul><li><b>Hyperacute rejection</b> is caused by preformed anti-donor antibodies. It is characterized by the binding of these antibodies to antigens on vascular endothelial cells. <a href="/wiki/Complement_system" title="Complement system">Complement activation</a> is involved and the effect is usually profound. Hyperacute rejection happens within minutes to hours after the transplant procedure.</li> <li><b>Acute rejection</b> is mediated by <a href="/wiki/T_cell" title="T cell">T cells</a> (versus <a href="/wiki/B_cell" title="B cell">B-cell</a>-mediated hyperacute rejection). It involves direct <a href="/wiki/Cytotoxicity" title="Cytotoxicity">cytotoxicity</a> and <a href="/wiki/Cytokine" title="Cytokine">cytokine</a> mediated pathways. Acute rejection is the most common and the primary target of immunosuppressive agents. Acute rejection is usually seen within days or weeks of the transplant.</li> <li><b>Chronic rejection</b> is the presence of any sign and symptom of rejection after one year. The cause of chronic rejection is still unknown, but an acute rejection is a strong predictor of chronic rejections.</li></ul> <div class="mw-heading mw-heading3"><h3 id="Biliary_complications">Biliary complications</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=5" title="Edit section: Biliary complications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Biliary complications include biliary stenosis, biliary leak, and ischemic cholangiopathy. The risk of ischemic cholangiopathy increases with longer durations of cold ischemia time, which is the time that the organ does not receive blood flow (after death/removal until graft placement).<sup id="cite_ref-Memeo_2-1" class="reference"><a href="#cite_note-Memeo-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Biliary complications are routinely treated with Endoscopic Retrograde Cholangiopancreatography (<a href="/wiki/ERCP" class="mw-redirect" title="ERCP">ERCP</a>), percutaneous drainage, or sometimes re-operation.<sup id="cite_ref-Lucey_2023_5-9" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Vascular_complications">Vascular complications</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=6" title="Edit section: Vascular complications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Vascular complications include <a href="/wiki/Hepatic_artery_thrombosis" title="Hepatic artery thrombosis">thrombosis</a>, stenosis, pseudoaneurysm, and rupture of the hepatic artery.<sup id="cite_ref-Piardi_1-2" class="reference"><a href="#cite_note-Piardi-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Venous complications occur less often compared with arterial complications, and include thrombosis or stenosis of the portal vein, hepatic vein, or vena cava.<sup id="cite_ref-Piardi_1-3" class="reference"><a href="#cite_note-Piardi-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Technique">Technique</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=7" title="Edit section: Technique"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Before transplantation, liver-support therapy might be indicated (bridging-to-transplantation). Artificial liver support like <a href="/wiki/Liver_dialysis" class="mw-redirect" title="Liver dialysis">liver dialysis</a> or bioartificial liver support concepts are currently under preclinical and clinical evaluation. Virtually all liver transplants are done in an orthotopic fashion; that is, the native liver is removed and the new liver is placed in the same anatomic location.<sup id="cite_ref-Mazza1_7-0" class="reference"><a href="#cite_note-Mazza1-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> The transplant operation can be conceptualized as consisting of the hepatectomy (liver removal) phase, the anhepatic (no liver) phase, and the postimplantation phase. The operation is done through a large incision in the upper abdomen. The hepatectomy involves division of all ligamentous attachments to the liver, as well as the common bile duct, hepatic artery, all three <a href="/wiki/Hepatic_veins" title="Hepatic veins">hepatic veins</a> and portal vein. Usually, the retrohepatic portion of the inferior vena cava is removed along with the liver, although an alternative technique preserves the recipient's vena cava ("piggyback" technique).<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2022)">citation needed</span></a></i>]</sup> </p><p>The donor's blood in the liver will be replaced by an ice-cold organ storage solution, such as UW (<a href="/wiki/Viaspan" title="Viaspan">Viaspan</a>) or <a href="/wiki/Histidine-tryptophan-ketoglutarate" title="Histidine-tryptophan-ketoglutarate">HTK</a>, until the allograft liver is implanted. Implantation involves anastomoses (connections) of the inferior vena cava, portal vein, and hepatic artery. After blood flow is restored to the new liver, the biliary (bile duct) anastomosis is constructed, either to the recipient's own bile duct or to the small intestine. The surgery usually takes between five and six hours, but may be longer or shorter due to the difficulty of the operation and the experience of the surgeon.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2024)">citation needed</span></a></i>]</sup> </p><p>The large majority of liver transplants use the entire liver from a non-living donor for the transplant, particularly for adult recipients. A major advance in pediatric liver transplantation was the development of reduced size liver transplantation, in which a portion of an adult liver is used for an infant or small child. Further developments in this area included split liver transplantation, in which one liver is used for transplants for two recipients, and living donor liver transplantation, in which a portion of a healthy person's liver is removed and used as the allograft. Living donor liver transplantation for pediatric recipients involves removal of approximately 20% of the liver (<a href="/wiki/Couinaud" class="mw-redirect" title="Couinaud">Couinaud</a> segments 2 and 3).<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2024)">citation needed</span></a></i>]</sup> </p><p>Further advance in liver transplant involves only resection of the lobe of the liver involved in tumors and the tumor-free lobe remains within the recipient. This speeds up the recovery and the patient stay in the hospital quickly shortens to within 5–7 days. </p><p><a href="/wiki/Radiofrequency_ablation" title="Radiofrequency ablation">Radiofrequency ablation</a> of the liver tumor can be used as a bridge while awaiting liver transplantation.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Cooling">Cooling</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=8" title="Edit section: Cooling"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Between removal from donor and transplantation into the recipient, the allograft liver is stored in a temperature-cooled preservation solution. The reduced temperature slows down the process of deterioration from normal metabolic processes, and the storage solution itself is designed to counteract the unwanted effects of cold ischemia. Although "static" cold storage method has long been standard technique, various dynamic preservation methods are under investigation. For example, systems which use a machine to pump blood through the explanted liver (after it is harvested from the body) during a transfer have met some success <sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2024)">citation needed</span></a></i>]</sup>(<i>see <a href="#Research_directions">Research section</a> for more</i>). </p> <div class="mw-heading mw-heading3"><h3 id="Living_donor_transplantation">Living donor transplantation</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=9" title="Edit section: Living donor transplantation"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:LDLT_volume_measure.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/en/thumb/1/17/LDLT_volume_measure.jpg/220px-LDLT_volume_measure.jpg" decoding="async" width="220" height="155" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/1/17/LDLT_volume_measure.jpg/330px-LDLT_volume_measure.jpg 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/1/17/LDLT_volume_measure.jpg/440px-LDLT_volume_measure.jpg 2x" data-file-width="511" data-file-height="359" /></a><figcaption>Volume rendering image created with <a href="/wiki/Computed_tomography" class="mw-redirect" title="Computed tomography">computed tomography</a>, which can be used to evaluate the volume of the liver of a potential donor</figcaption></figure> <p><b>Living donor liver transplantation</b> (LDLT) has emerged in recent decades as a critical <a href="/wiki/Surgery" title="Surgery">surgical</a> option for patients with end stage liver disease, such as <a href="/wiki/Cirrhosis" title="Cirrhosis">cirrhosis</a> and/or <a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">hepatocellular carcinoma</a> often attributable to one or more of the following: long-term <a href="/wiki/Alcohol_use_disorder" class="mw-redirect" title="Alcohol use disorder">alcohol use disorder</a>, long-term untreated <a href="/wiki/Hepatitis_C" title="Hepatitis C">hepatitis C</a> infection, long-term untreated <a href="/wiki/Hepatitis_B" title="Hepatitis B">hepatitis B</a> infection. The concept of LDLT is based on (1) the remarkable regenerative capacities of the human liver and (2) the widespread shortage of <a href="/wiki/Cadaver" title="Cadaver">cadaveric</a> livers for patients awaiting <a href="/wiki/Organ_transplant" class="mw-redirect" title="Organ transplant">transplant</a>. In LDLT, a piece of healthy liver is surgically removed from a living person and transplanted into a recipient, immediately after the recipient's diseased liver has been entirely removed.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2024)">citation needed</span></a></i>]</sup> </p><p>Historically, LDLT began with terminal pediatric patients, whose parents were motivated to risk donating a portion of their compatible healthy livers to replace their children's failing ones. The first report of successful LDLT was by <a href="/wiki/Silvano_Raia" title="Silvano Raia">Silvano Raia</a> at the <a href="/wiki/University_of_S%C3%A3o_Paulo" title="University of São Paulo">University of São Paulo</a> Faculty of Medicine in July 1989.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citing_sources" title="Wikipedia:Citing sources"><span title="This citation requires a reference to the specific page or range of pages in which the material appears. (June 2022)">page needed</span></a></i>]</sup><sup id="cite_ref-Google_Books_10-0" class="reference"><a href="#cite_note-Google_Books-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> It was followed by <a href="/wiki/Christoph_Broelsch" title="Christoph Broelsch">Christoph Broelsch</a> at the <a href="/wiki/University_of_Chicago_Medical_Center" title="University of Chicago Medical Center">University of Chicago Medical Center</a> in November 1989, when two-year-old Alyssa Smith received a portion of her mother's liver.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Surgeons eventually realized that adult-to-adult LDLT was also possible, and now the practice is common in a few reputable medical institutes. It is considered more technically demanding than even standard, cadaveric donor liver transplantation, and also poses the ethical problems underlying the indication of a major surgical operation (<a href="/wiki/Hemihepatectomy" class="mw-redirect" title="Hemihepatectomy">hemihepatectomy</a> or related procedure) on a healthy human being. In various case series, the risk of complications in the donor is around 10%, and very occasionally a second operation is needed. Common problems are <a href="/wiki/Biliary_fistula" title="Biliary fistula">biliary fistula</a>, <a href="/w/index.php?title=Gastric_stasis&action=edit&redlink=1" class="new" title="Gastric stasis (page does not exist)">gastric stasis</a> and <a href="/wiki/Infection" title="Infection">infections</a>; they are more common after removal of the right lobe of the liver. Death after LDLT has been reported at 0% (Japan), 0.3% (USA) and <1% (Europe), with risks likely to decrease further as surgeons gain more experience in this procedure.<sup id="cite_ref-FOOTNOTEUmeshitaFujiwaraKiyosawaMakuuchi2003_12-0" class="reference"><a href="#cite_note-FOOTNOTEUmeshitaFujiwaraKiyosawaMakuuchi2003-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> Since the law was changed to permit altruistic non-directed living organ donations in the UK in 2006, the first altruistic living liver donation took place in Britain in December 2012.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p><p>In a typical adult recipient LDLT, 55 to 70% of the liver (the right lobe) is removed from a healthy living donor. The donor's liver will regenerate approaching 100% function within 4–6 weeks, and will almost reach full volumetric size with recapitulation of the normal structure soon thereafter. It may be possible to remove up to 70% of the liver from a healthy living donor without harm in most cases. The transplanted portion will reach full function and the appropriate size in the recipient as well, although it will take longer than for the donor.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>Living donors are faced with risks and/or complications after the surgery. Blood clots and biliary problems have the possibility of arising in the donor post-op, but these issues are remedied fairly easily. Although death is a risk that a living donor must be willing to accept prior to the surgery, the mortality rate of living donors in the United States is low. The LDLT donor's immune system does diminish as a result of the liver regenerating, so certain foods which would normally cause an upset stomach could cause serious illness.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag needs references to reliable medical sources. (May 2018)">medical citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading4"><h4 id="Donor_requirements">Donor requirements</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=10" title="Edit section: Donor requirements"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:CT_scan_showing_liver_and_kidney.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e3/CT_scan_showing_liver_and_kidney.jpg/220px-CT_scan_showing_liver_and_kidney.jpg" decoding="async" width="220" height="184" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e3/CT_scan_showing_liver_and_kidney.jpg/330px-CT_scan_showing_liver_and_kidney.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e3/CT_scan_showing_liver_and_kidney.jpg/440px-CT_scan_showing_liver_and_kidney.jpg 2x" data-file-width="503" data-file-height="420" /></a><figcaption><a href="/wiki/CT_scan" title="CT scan">CT scan</a> performed for evaluation of a potential donor. The image shows an unusual variation of hepatic artery. The left hepatic artery supplies not only left lobe but also segment 8. The anatomy makes right lobe donation impossible. Even used as left lobe or lateral segment donation, it would be very technically challenging in anastomosing the small arteries.</figcaption></figure> <p>Any member of the family, parent, sibling, child, spouse or a volunteer can donate their liver. The criteria<sup id="cite_ref-Living_Donor_Liver_Transplantation_FAQ_-_Columbia_University_Dept_of_Surgery_15-0" class="reference"><a href="#cite_note-Living_Donor_Liver_Transplantation_FAQ_-_Columbia_University_Dept_of_Surgery-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Who_can_be_a_Donor?_-_University_of_Maryland_Medical_Center_16-0" class="reference"><a href="#cite_note-Who_can_be_a_Donor?_-_University_of_Maryland_Medical_Center-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> for a liver donation include: </p> <ul><li>Being in good health<sup id="cite_ref-Living_Donor_Liver_Transplantation_FAQ_-_Columbia_University_Dept_of_Surgery_15-1" class="reference"><a href="#cite_note-Living_Donor_Liver_Transplantation_FAQ_-_Columbia_University_Dept_of_Surgery-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup></li> <li>Having a <a href="/wiki/Blood_type" title="Blood type">blood type</a> that matches or is compatible with the recipient's,<sup id="cite_ref-Living_Donor_Liver_Transplantation_FAQ_-_Columbia_University_Dept_of_Surgery_15-2" class="reference"><a href="#cite_note-Living_Donor_Liver_Transplantation_FAQ_-_Columbia_University_Dept_of_Surgery-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> although some centres now perform blood group incompatible transplants with special immunosuppression protocols.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag needs references to reliable medical sources. (August 2019)">medical citation needed</span></a></i>]</sup></li> <li>Having a charitable desire of donation without financial motivation<sup id="cite_ref-Living_Donor_Liver_Transplantation_FAQ_-_Columbia_University_Dept_of_Surgery_15-3" class="reference"><a href="#cite_note-Living_Donor_Liver_Transplantation_FAQ_-_Columbia_University_Dept_of_Surgery-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup></li> <li>Being between 20 and 60 years old<sup id="cite_ref-Living_Donor_Liver_Transplantation_FAQ_-_Columbia_University_Dept_of_Surgery_15-4" class="reference"><a href="#cite_note-Living_Donor_Liver_Transplantation_FAQ_-_Columbia_University_Dept_of_Surgery-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> (18 to 60 years old in some places<sup id="cite_ref-Who_can_be_a_Donor?_-_University_of_Maryland_Medical_Center_16-1" class="reference"><a href="#cite_note-Who_can_be_a_Donor?_-_University_of_Maryland_Medical_Center-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup>)</li> <li>Have an important personal relationship with the recipient<sup id="cite_ref-Who_can_be_a_Donor?_-_University_of_Maryland_Medical_Center_16-2" class="reference"><a href="#cite_note-Who_can_be_a_Donor?_-_University_of_Maryland_Medical_Center-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup></li> <li>Being of similar or larger size than the recipient<sup id="cite_ref-Who_can_be_a_Donor?_-_University_of_Maryland_Medical_Center_16-3" class="reference"><a href="#cite_note-Who_can_be_a_Donor?_-_University_of_Maryland_Medical_Center-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup></li> <li>Before one becomes a living donor, the donor must undergo testing to ensure that the individual is physically fit, in excellent health, and not having uncontrolled high blood pressure, liver disease, diabetes or heart disease.<sup id="cite_ref-Who_can_be_a_Donor?_-_University_of_Maryland_Medical_Center_16-4" class="reference"><a href="#cite_note-Who_can_be_a_Donor?_-_University_of_Maryland_Medical_Center-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> Sometimes CT scans or MRIs are done to image the liver. In most cases, the work up is done in 2–3 weeks.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2024)">citation needed</span></a></i>]</sup></li></ul> <div class="mw-heading mw-heading4"><h4 id="Complications">Complications</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=11" title="Edit section: Complications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Living donor surgery is done at a major center. Very few individuals require any <a href="/wiki/Blood_transfusions" class="mw-redirect" title="Blood transfusions">blood transfusions</a> during or after surgery. All potential donors should know there is a 0.5 to 1.0 percent chance of death<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2022)">citation needed</span></a></i>]</sup>. Other risks of donating a liver include bleeding, infection, painful incision, possibility of <a href="/wiki/Blood_clots" class="mw-redirect" title="Blood clots">blood clots</a> and a prolonged recovery.<sup id="cite_ref-Liver_Transplant_17-0" class="reference"><a href="#cite_note-Liver_Transplant-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> The vast majority of donors enjoy complete and full recovery within 2–3 months.<sup id="cite_ref-Post_Operative_Care_18-0" class="reference"><a href="#cite_note-Post_Operative_Care-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Pediatric_transplantation">Pediatric transplantation</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=12" title="Edit section: Pediatric transplantation"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Left_Liver_Transplant.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f1/Left_Liver_Transplant.jpg/220px-Left_Liver_Transplant.jpg" decoding="async" width="220" height="198" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f1/Left_Liver_Transplant.jpg/330px-Left_Liver_Transplant.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f1/Left_Liver_Transplant.jpg/440px-Left_Liver_Transplant.jpg 2x" data-file-width="3659" data-file-height="3290" /></a><figcaption>In children, due to their smaller <a href="/wiki/Abdominal_cavity" title="Abdominal cavity">abdominal cavity</a>, there is only space for a partial segment of liver, usually the left lobe of the donor's liver. This is also known as a "split" liver transplant. There are four <a href="/wiki/Anastomoses" class="mw-redirect" title="Anastomoses">anastomoses</a> required for a "split" liver transplant: hepaticojejunostomy (<a href="/wiki/Biliary_tract" title="Biliary tract">biliary</a> drainage connecting to a roux limb of <a href="/wiki/Jejunum" title="Jejunum">jejunum</a>), <a href="/wiki/Hepatic_portal_vein" class="mw-redirect" title="Hepatic portal vein">portal venous</a> anatomosis, <a href="/wiki/Hepatic_artery_proper" title="Hepatic artery proper">hepatic arterial</a> anastomosis, and <a href="/wiki/Inferior_vena_cava" title="Inferior vena cava">inferior vena cava</a> anastomosis. </figcaption></figure> <p>In children, living liver donor transplantation has become very accepted. The accessibility of adult parents who want to donate a piece of the liver for their children/infants has reduced the number of children who would have otherwise died waiting for a transplant. Having a parent as a donor also has made it a lot easier for children – because both patients are in the same hospital and can help boost each other's morale.<sup id="cite_ref-What_I_need_to_know_about_Liver_Transplantation_19-0" class="reference"><a href="#cite_note-What_I_need_to_know_about_Liver_Transplantation-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Benefits">Benefits</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=13" title="Edit section: Benefits"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There are several advantages of living liver donor transplantation over cadaveric donor transplantation, including: </p> <ul><li>Transplant can be done on an elective basis because the donor is readily available</li> <li>There are fewer possibilities for complications and death than there would be while waiting for a cadaveric organ donor</li> <li>Because of donor shortages, <a href="/wiki/UNOS" class="mw-redirect" title="UNOS">UNOS</a> has placed limits on cadaveric organ allocation to foreigners who seek medical help in the USA. With the availability of living donor transplantation, this will now allow foreigners a new opportunity to seek medical care in the USA.</li></ul> <div class="mw-heading mw-heading4"><h4 id="Screening_for_donors">Screening for donors</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=14" title="Edit section: Screening for donors"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Living donor transplantation is a multidisciplinary approach. All living liver donors undergo medical evaluation. Every hospital which performs transplants has dedicated nurses that provide specific information about the procedure and answer questions that families may have. During the evaluation process, confidentiality is assured on the potential donor. Every effort is made to ensure that organ donation is not made by coercion from other family members. The transplant team provides both the donor and family thorough counseling and support which continues until full recovery is made.<sup id="cite_ref-Liver_Donor:_All_you_need_to_know_20-0" class="reference"><a href="#cite_note-Liver_Donor:_All_you_need_to_know-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </p><p>All donors are assessed medically to ensure that they can undergo the surgery. Blood type of the donor and recipient must be compatible but not always identical. Other things assessed prior to surgery include the anatomy of the donor liver. However, even with mild variations in <a href="/wiki/Blood_vessels" class="mw-redirect" title="Blood vessels">blood vessels</a> and <a href="/wiki/Bile_duct" title="Bile duct">bile duct</a>, surgeons today are able to perform transplantation without problems. The most important criterion for a living liver donor is to be in excellent health.<sup id="cite_ref-Liver_Transplant_Program_And_Center_for_Liver_Disease_21-0" class="reference"><a href="#cite_note-Liver_Transplant_Program_And_Center_for_Liver_Disease-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Post-transplant_immunosuppression">Post-transplant immunosuppression</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=15" title="Edit section: Post-transplant immunosuppression"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Like most other allografts, a liver transplant will be <a href="/wiki/Transplant_rejection" title="Transplant rejection">rejected</a> by the recipient unless <a href="/wiki/Immunosuppression" title="Immunosuppression">immunosuppressive</a> drugs are used. The immunosuppressive regimens for all solid organ transplants are fairly similar, and a variety of agents are now available. Most liver transplant recipients receive <a href="/wiki/Corticosteroid" title="Corticosteroid">corticosteroids</a> plus a calcineurin inhibitor such as <a href="/wiki/Tacrolimus" title="Tacrolimus">tacrolimus</a> or <a href="/wiki/Ciclosporin" title="Ciclosporin">ciclosporin</a>, (also spelled cyclosporine and cyclosporin) plus a purine antagonist such as <a href="/wiki/Mycophenolic_acid" title="Mycophenolic acid">mycophenolate mofetil</a>. Clinical outcome is better with tacrolimus than with ciclosporin during the first year of liver transplantation.<sup id="cite_ref-FOOTNOTEHaddadMcAlisterRenoufMalthaner2006_22-0" class="reference"><a href="#cite_note-FOOTNOTEHaddadMcAlisterRenoufMalthaner2006-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-FOOTNOTEO'GradyBurroughsHardyElbourne2002_23-0" class="reference"><a href="#cite_note-FOOTNOTEO'GradyBurroughsHardyElbourne2002-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> If the patient has a co-morbidity such as active hepatitis B, high doses of hepatitis B immunoglubins are administered in liver transplant patients.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2024)">citation needed</span></a></i>]</sup> </p><p>Due to both the pharmacological immunosuppression and the immunosuppression of underlying liver disease, vaccinations against vaccination-preventable diseases are highly recommended before and after liver transplantation. Vaccine hesitancy in transplant recipients is less than in the general population.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> <sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> Vaccinations are preferably administered to the recipient before the transplant, as post-transplant immunosuppression leads to reduced vaccine effectiveness.<sup id="cite_ref-Lucey_2023_5-10" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p><br /> Liver transplantation is unique in that the risk of chronic rejection also decreases over time, although the great majority of recipients need to take immunosuppressive medication for the rest of their lives. It is possible to be slowly taken off anti rejection medication but only in certain cases. It is theorized that the liver may play a yet-unknown role in the maturation of certain cells pertaining to the <a href="/wiki/Immune_system" title="Immune system">immune system</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag needs references to reliable medical sources. (May 2014)">medical citation needed</span></a></i>]</sup> There is at least one study by <a href="/wiki/Thomas_E._Starzl" class="mw-redirect" title="Thomas E. Starzl">Thomas E. Starzl</a>'s team at the <a href="/wiki/University_of_Pittsburgh" title="University of Pittsburgh">University of Pittsburgh</a> which consisted of <a href="/wiki/Bone_marrow" title="Bone marrow">bone marrow</a> <a href="/wiki/Biopsies" class="mw-redirect" title="Biopsies">biopsies</a> taken from such patients which demonstrate genotypic <a href="/wiki/Chimerism" class="mw-redirect" title="Chimerism">chimerism</a> in the bone marrow of liver transplant recipients.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2024)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Recovery_and_outcomes">Recovery and outcomes</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=16" title="Edit section: Recovery and outcomes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The prognosis following liver transplant is variable, depending on overall health, technical success of the surgery, and the underlying disease process affecting the liver.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> There is no exact model to predict survival rates; those with transplant have a 58% chance of surviving 15 years.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> Failure of the new liver (<b>primary nonfunction in liver transplantation</b> or <b>PNF</b>) occurs in 10% to 15% of all cases. These percentages are contributed to by many complications. Early graft failure is probably due to preexisting disease of the donated organ. Others include technical flaws during surgery such as revascularization that may lead to a nonfunctioning graft.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2024)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=17" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>As with many experimental models used in early surgical research, the first attempts at liver transplantation were performed on dogs. The earliest published reports of canine liver transplantations were performed in 1954 by Vittorio Staudacher at Ospedale Maggiore Policlinico in Milan, Italy. This initial attempt varied significantly from contemporary techniques; for example, Staudacher reported "arterialization" of the donor portal vein via the recipient hepatic artery, and use of cholecystostomy for biliary drainage.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> </p><p>The first attempted <a href="/wiki/Human" title="Human">human</a> liver transplant was performed in 1963 by <a href="/wiki/Thomas_Starzl" title="Thomas Starzl">Thomas Starzl</a>, although the pediatric patient died intraoperatively due to uncontrolled bleeding.<sup id="cite_ref-auto_29-0" class="reference"><a href="#cite_note-auto-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> Multiple subsequent attempts by various surgeons remained unsuccessful until 1967, when Starzl transplanted a 19-month-old girl with <a href="/wiki/Hepatoblastoma" title="Hepatoblastoma">hepatoblastoma</a> who was able to survive for over one year before dying of metastatic disease.<sup id="cite_ref-auto_29-1" class="reference"><a href="#cite_note-auto-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> Despite the development of viable surgical techniques, liver transplantation remained experimental through the 1970s, with one year patient survival in the vicinity of 25%. The introduction of <a href="/wiki/Ciclosporin" title="Ciclosporin">ciclosporin</a> by Sir <a href="/wiki/Roy_Calne" title="Roy Calne">Roy Calne</a>, Professor of Surgery Cambridge, markedly improved patient outcomes, and the 1980s saw recognition of liver transplantation as a standard clinical treatment for both adult and pediatric patients with appropriate indications.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag needs references to reliable medical sources. (July 2017)">medical citation needed</span></a></i>]</sup> Liver transplantation is now performed at over one hundred centers in the US, as well as numerous centres in Europe and elsewhere. </p><p>The limited supply of <a href="/wiki/Liver" title="Liver">liver</a> <a href="/wiki/Allograft" class="mw-redirect" title="Allograft">allografts</a> from non-living donors relative to the number of potential recipients spurred the development of <a href="#Living_donor_transplantation">living donor liver transplantation</a>. The first altruistic living liver donation in Britain was performed in December 2012 in St James University Hospital Leeds. </p> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=18" title="Edit section: Society and culture"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Famous_liver_transplant_recipients">Famous liver transplant recipients</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=19" title="Edit section: Famous liver transplant recipients"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>See also: <a href="/wiki/Category:Liver_transplant_recipients" title="Category:Liver transplant recipients">Category:Liver transplant recipients</a> and <a href="/wiki/List_of_organ_transplant_donors_and_recipients" title="List of organ transplant donors and recipients">List of organ transplant donors and recipients</a> </p> <ul><li><a href="/wiki/Eric_Abidal" title="Eric Abidal">Eric Abidal</a> (born 1979), French footballer (<a href="/wiki/Olympique_Lyonnais" title="Olympique Lyonnais">Olympique Lyonnais</a>, <a href="/wiki/FC_Barcelona" title="FC Barcelona">FC Barcelona</a>), <small>transplant in 2012</small></li> <li><a href="/wiki/Gregg_Allman" title="Gregg Allman">Gregg Allman</a> (1947–2017), American musician (<a href="/wiki/The_Allman_Brothers_Band" title="The Allman Brothers Band">The Allman Brothers Band</a>), <small>transplant in 2010 (survival: 7 years)</small></li> <li><a href="/wiki/George_Best" title="George Best">George Best</a> (1946–2005), Northern-Irish footballer (<a href="/wiki/Manchester_United_F.C." title="Manchester United F.C.">Manchester United</a>), <small>transplant in 2002 (survival: 3 years)</small></li> <li><a href="/wiki/David_Bird_(journalist)" title="David Bird (journalist)">David Bird</a> (1959–2014), American journalist (<i><a href="/wiki/The_Wall_Street_Journal" title="The Wall Street Journal">The Wall Street Journal</a></i>), <small>transplant in 2004 (survival: 10 years)</small></li> <li><a href="/wiki/Jack_Bruce" title="Jack Bruce">Jack Bruce</a> (1943–2014), Scottish musician (<a href="/wiki/Cream_(band)" title="Cream (band)">Cream</a>), <small>transplant in 2003 (survival: 11 years)</small></li> <li><a href="/wiki/Frank_Bough" title="Frank Bough">Frank Bough</a> (1933–2020), English television presenter, <small>transplant in 2001 (survival: 19 years)</small></li> <li><a href="/wiki/Bob_Casey_Sr." title="Bob Casey Sr.">Robert P. Casey</a> (1932–2000), American politician (<a href="/wiki/List_of_governors_of_Pennsylvania" title="List of governors of Pennsylvania">42nd Governor of Pennsylvania</a>), <small>transplant in 1993 (survival: 7 years)</small></li> <li><a href="/wiki/David_Crosby" title="David Crosby">David Crosby</a> (1941–2023), American musician (<a href="/wiki/The_Byrds" title="The Byrds">The Byrds</a>, <a href="/wiki/Crosby,_Stills,_Nash_%26_Young" title="Crosby, Stills, Nash & Young">Crosby Stills, Nash (& Young)</a>), <small>transplant in 1994 (survival: 28 years)</small></li> <li><a href="/wiki/Gerald_Durrell" title="Gerald Durrell">Gerald Durrell</a> (1925–1995), British zookeeper (<a href="/wiki/Jersey_Zoo" title="Jersey Zoo">Durrell Wildlife Park</a>), <small>transplant in 1994 (survival <1 year)</small></li> <li><a href="/wiki/Vaughn_Eshelman" title="Vaughn Eshelman">Vaughn Eshelman</a> (1969–2018), American Major League Baseball pitcher (<a href="/wiki/Boston_Red_Sox" title="Boston Red Sox">Boston Red Sox</a>), <small>transplant in 2018 (survival <6 months)</small></li> <li><a href="/wiki/Shelley_Fabares" title="Shelley Fabares">Shelley Fabares</a> (born 1944), American actress (<i><a href="/wiki/The_Donna_Reed_Show" title="The Donna Reed Show">The Donna Reed Show</a></i>, <i><a href="/wiki/Coach_(TV_series)" title="Coach (TV series)">Coach</a></i>) and singer ("<a href="/wiki/Johnny_Angel_(song)" title="Johnny Angel (song)">Johnny Angel</a>"), <small>transplant in 2000</small></li> <li><a href="/wiki/Freddy_Fender" title="Freddy Fender">Freddy Fender</a> (1937–2006), American musician ("<a href="/wiki/Before_the_Next_Teardrop_Falls_(song)" title="Before the Next Teardrop Falls (song)">Before the Next Teardrop Falls</a>," "<a href="/wiki/Wasted_Days_and_Wasted_Nights" title="Wasted Days and Wasted Nights">Wasted Days and Wasted Nights</a>"), <small>transplant in 2004 (survival: 2 years)</small></li> <li><a href="/wiki/Superstar_Billy_Graham" class="mw-redirect" title="Superstar Billy Graham">"Superstar" Billy Graham</a> (1943–2023), American wrestler (<a href="/wiki/WWE" title="WWE">WWF</a>), <small>transplant in 2002 (survival: 20 years)</small></li> <li><a href="/wiki/Larry_Hagman" title="Larry Hagman">Larry Hagman</a> (1931–2012), American actor (<i><a href="/wiki/Dallas_(1978_TV_series)" title="Dallas (1978 TV series)">Dallas</a></i>, <i><a href="/wiki/Harry_and_Tonto" title="Harry and Tonto">Harry and Tonto</a></i>, <i><a href="/wiki/Nixon_(film)" title="Nixon (film)">Nixon</a></i>, <i><a href="/wiki/Primary_Colors_(film)" title="Primary Colors (film)">Primary Colors</a></i>), <small>transplant in 1995 (survival: 17 years)</small></li> <li><a href="/wiki/Dahlan_Iskan" title="Dahlan Iskan">Dahlan Iskan</a> (born 1951), Indonesian minister, <small>transplant in 1987</small></li> <li><a href="/wiki/Steve_Jobs" title="Steve Jobs">Steve Jobs</a> (1955–2011), American businessman (<a href="/wiki/Apple_Inc." title="Apple Inc.">Apple Inc.</a>), <small>transplant in 2009 (survival: 2 years)</small></li> <li><a href="/wiki/Chris_Klug" title="Chris Klug">Chris Klug</a> (born 1972), American snowboarder, <small>transplant in 2000</small></li> <li><a href="/wiki/Evel_Knievel" title="Evel Knievel">Evel Knievel</a> (1938–2007), American stunt performer, <small>transplant in 1999 (survival: 8 years)</small></li> <li><a href="/wiki/Chris_LeDoux" title="Chris LeDoux">Chris LeDoux</a> (1948–2005), American musician and rodeo champion, <small>transplant in 2000 (survival: 5 years)</small></li> <li><a href="/wiki/K._W._Lee" title="K. W. Lee">Kyung Won Lee</a> (born 1928), Korean-American journalist, <small>transplant in 1992</small></li> <li><a href="/wiki/Phil_Lesh" title="Phil Lesh">Phil Lesh</a> (1940-2025), American musician (<a href="/wiki/Grateful_Dead" title="Grateful Dead">Grateful Dead</a>), <small>transplant in 1998 (Survival: 16 years)</small></li> <li><a href="/wiki/Linda_Lovelace" title="Linda Lovelace">Linda Lovelace</a> (1949–2002), American pornographic actress (<i><a href="/wiki/Deep_Throat_(film)" title="Deep Throat (film)">Deep Throat</a></i>), <small>transplant in 1987 (survival: 15 years)</small></li> <li><a href="/wiki/Mickey_Mantle" title="Mickey Mantle">Mickey Mantle</a> (1931–1995), American baseball player (<a href="/wiki/New_York_Yankees" title="New York Yankees">New York Yankees</a>), <small>transplant in 1995 (survival: <1 year)</small></li> <li><a href="/wiki/Mike_MacDonald_(comedian)" title="Mike MacDonald (comedian)">Mike MacDonald</a> (1954–2018), Canadian comedian and actor (<i><a href="/wiki/Mr._Nice_Guy_(1987_film)" title="Mr. Nice Guy (1987 film)">Mr. Nice Guy</a></i>), <small>transplant in 2013 (survival: 5 years)</small></li> <li><a href="/wiki/Jim_Nabors" title="Jim Nabors">Jim Nabors</a> (1930–2017), American actor (<i><a href="/wiki/The_Andy_Griffith_Show" title="The Andy Griffith Show">The Andy Griffith Show</a></i>), <small>transplant in 1994 (survival: 23 years)</small></li> <li><a href="/wiki/John_Phillips_(musician)" title="John Phillips (musician)">John Phillips</a> (1935–2001), American musician (<a href="/wiki/The_Mamas_%26_the_Papas" title="The Mamas & the Papas">The Mamas & the Papas</a>), <small>transplant in 1992 (survival: 9 years)</small></li> <li><a href="/wiki/James_Redford_(filmmaker)" title="James Redford (filmmaker)">James Redford</a> (1962–2020), American documentary filmmaker and environmentalist, <small>transplant in 1993 (survival: 27 years)</small></li> <li><a href="/wiki/Lou_Reed" title="Lou Reed">Lou Reed</a> (1942–2013), American musician (<a href="/wiki/The_Velvet_Underground" title="The Velvet Underground">The Velvet Underground</a>), <small>transplant in 2013 (survival: <1 year)</small></li> <li><a href="/wiki/U._Srinivas" title="U. Srinivas">U. Srinivas</a> (1969–2014), Indian musician, <small>transplant in 2014 (survival: <1 year)</small></li> <li><a href="/wiki/Mike_IX_Williams" title="Mike IX Williams">Mike IX Williams</a> (1968), American vocalist and songwriter (<a href="/wiki/Eyehategod" title="Eyehategod">Eyehategod</a>), <small>transplant in 2016</small></li></ul> <div class="mw-heading mw-heading2"><h2 id="Research_directions">Research directions</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=20" title="Edit section: Research directions"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Cooling_2">Cooling</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=21" title="Edit section: Cooling"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There is increasing interest in improving methods for allograft preservation following organ harvesting. The standard "static cold storage" technique relies on flushing a liver with a preservation solution and then placing it in static cold storage at a decreased temperature (usually 4 degrees Celsius) to slow down anaerobic metabolic breakdown.<sup id="cite_ref-Lucey_2023_5-11" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> An alternative method involves machine perfusion, in which oxygenated, preservation solutions are continually pumped through the liver prior to transplantation. This is currently being investigated with cold (hypothermic), body temperature (normothermic), and under body temperature (subnormothermic) preservation solutions. Hypothermic machine perfusion has been used successfully at Columbia University and at the University of Zurich.<sup id="cite_ref-FOOTNOTEGrahamGuarrera2015_30-0" class="reference"><a href="#cite_note-FOOTNOTEGrahamGuarrera2015-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> A randomized controlled clinical trial comparing normothermic machine preservation with conventional cold storage showed less donor liver injury, less discarded donor livers (due to suboptimal condition), better early function, and longer preservation times compared with static cold stored livers. Graft survival and patient survival after transplant were similar with both approaches.<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> Machine perfusion prior to transplant is associated with decreased tissue re-perfusion ischemic injury (a process in which liver cells are damaged as a statically stored liver is re-perfused after transplant) as well as a decreased risk of intrahepatic biliary strictures.<sup id="cite_ref-Lucey_2023_5-12" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>A 2014 study showed that the liver preservation time could be significantly extended using a supercooling technique, which preserves the liver at subzero temperatures (-6 °C)<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Normothermic_Regional_Perfusion">Normothermic Regional Perfusion</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=22" title="Edit section: Normothermic Regional Perfusion"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Donation after circulatory death (DCD) has become an increasingly important source of organs for transplantation, with categories ranging from uncontrolled to controlled DCD (cDCD) donors. Despite its growing use, DCD organs generally suffer from warm ischemia injuries, leading to fewer and lower-quality organs compared to those from donation after brain death (DBD).<sup id="cite_ref-:0_34-0" class="reference"><a href="#cite_note-:0-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> To mitigate these issues, there has been a rising interest in normothermic regional perfusion (NRP), a technique that temporarily restores oxygenated blood flow to organs after death, thereby improving their viability prior to recovery.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2024)">citation needed</span></a></i>]</sup> </p><p>NRP works by reversing the detrimental effects of warm ischemia on cellular energy substrates and antioxidants, thereby reconditioning the organs before transplantation. This technique, often facilitated by extracorporeal membrane oxygenation (ECMO) technology, allows for organ assessment and optimization, reducing the risk of graft failure.<sup id="cite_ref-:0_34-1" class="reference"><a href="#cite_note-:0-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> NRP can be established either abdominally or thoracoabdominally, depending on the intended organs for transplantation, with specific techniques and monitoring protocols in place to ensure optimal outcomes. Clinical outcomes of NRP in DCD organ transplantation have shown promising results, particularly in kidney and liver transplantation, with lower rates of complications and improved graft survival compared to traditional preservation methods.<sup id="cite_ref-:0_34-2" class="reference"><a href="#cite_note-:0-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> Through the utilization of NRP, <a href="/w/index.php?title=Constantino_Fondevila&action=edit&redlink=1" class="new" title="Constantino Fondevila (page does not exist)">Dr. Fondevila</a> et al. at <a href="/wiki/Hospital_Universitario_La_Paz" title="Hospital Universitario La Paz">Hospital Universitario La Paz</a> have achieved successful transplantation of livers that have undergone extensive warm ischemic periods of up to 2.5 hours prior to recovery.<sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> This has resulted in biliary complication and graft survival rates comparable to those observed in controlled DCD livers that have experienced significantly less warm ischemia.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> </p><p>While ethical considerations remain, especially regarding the use of NRP in controlled DCD scenarios, ongoing research aims to address these concerns and expand the application of NRP to other organ types, ultimately increasing the availability of viable organs for transplantation and improving outcomes for patients with end-stage organ disease<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2024)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Herpesvirus_6_Reactivation">Herpesvirus 6 Reactivation</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=23" title="Edit section: Herpesvirus 6 Reactivation"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A study published in <i>The Journal of Infectious Diseases</i> in 2024 investigated the reactivation of inherited chromosomally integrated human herpesvirus 6 (iciHHV-6B) in a liver transplant recipient and its impact on the graft. The research, conducted by Hannolainen et al., utilized hybrid capture sequencing and various molecular techniques to analyze the viral sequences and host immune response. The findings demonstrated active replication of iciHHV-6B within the graft tissue and significant immune activation, suggesting the pathological impact of viral reactivation on transplant outcomes. The study highlights the importance of monitoring iciHHV-6 reactivation in liver transplant recipients.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Special_populations">Special populations</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=24" title="Edit section: Special populations"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Alcohol_dependence">Alcohol dependence</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=25" title="Edit section: Alcohol dependence"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The high incidence of liver transplants given to those with alcoholic <a href="/wiki/Cirrhosis" title="Cirrhosis">cirrhosis</a> has led to a recurring controversy regarding the eligibility of such patients for liver transplant. The controversy stems from the view of <a href="/wiki/Alcoholism" title="Alcoholism">alcoholism</a> as a self-inflicted disease and the perception that those with alcohol-induced damage are depriving other patients who could be considered more deserving.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> It is an important part of the selection process to differentiate transplant candidates who have alcohol use disorder as opposed to those who were susceptible to non-dependent alcohol use. The latter who gain control of alcohol use have a good prognosis following transplantation. Once a diagnosis of alcoholism has been established, however, it is necessary to assess the likelihood of future sobriety.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="HIV">HIV</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=26" title="Edit section: HIV"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Historically, HIV was considered an absolute contraindication to liver transplantation. This was in part due to concern that the infection would be worsened by the immunosuppressive medication which is required after transplantation.<sup id="cite_ref-Varma_4-3" class="reference"><a href="#cite_note-Varma-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>However, with the advent of highly active antiretroviral therapy (HAART), people with HIV have much improved prognosis. HIV controlled with HAART is no longer a contraindication to liver transplantation.<sup id="cite_ref-Lucey_2023_5-13" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Uncontrolled HIV disease (AIDS) remains an absolute contraindication.<sup id="cite_ref-Lucey_2023_5-14" class="reference"><a href="#cite_note-Lucey_2023-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Medical_cannabis">Medical cannabis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=27" title="Edit section: Medical cannabis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Medical criteria for transplant often require "lack of substance abuse". The changing status of cannabis has resulted in many patients who never abused any substance – merely used one – either being turned down for transplants, forced to stop a useful medicine suggested by their doctors, or both.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2024)">citation needed</span></a></i>]</sup> </p><p>For example, in 2011, <a href="/wiki/Cedars-Sinai_Medical_Center" title="Cedars-Sinai Medical Center">Cedars-Sinai Medical Center</a> denied a liver transplant to <a href="/wiki/Medical_cannabis" title="Medical cannabis">medical cannabis</a> patient Norman Smith. They removed Mr. Smith from a transplant waiting list for "non-compliance of our substance abuse contract",<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> despite his own oncologist at Cedars-Sinai having recommended that he use the cannabis for his pain and chemotherapy.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> Dr. Steven D. Colquhoun, director of the Liver Transplant Program, said that the hospital "must consider issues of substance abuse seriously", but the transplant center did not seriously consider whether Mr. Smith was "using" cannabis versus "abusing" it.<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> In 2012, Cedars-Sinai denied a liver transplant to a second patient, Toni Trujillo, after her Cedars-Sinai doctors knew and approved of her legal use of medical cannabis. In both cases, the patients acceded to the hospital's demand and stopped using cannabis, despite its therapeutic benefits for them, but were both sent back to the bottom of the transplant list.<sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> Smith's death inspired <a href="/wiki/Americans_for_Safe_Access" title="Americans for Safe Access">Americans for Safe Access</a> to lobby for the California Medical Cannabis Organ Transplant Act (AB 258), which was enacted in July 2015 to protect future patients from dying at the hands of medical establishments prejudiced against the legal use of medical cannabis.<sup id="cite_ref-45" class="reference"><a href="#cite_note-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=28" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-Piardi-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-Piardi_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Piardi_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Piardi_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Piardi_1-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFPiardiLhuaireBrunoMemeo2016" class="citation journal cs1">Piardi, T; 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G.; Burroughs, A.; Hardy, P.; Elbourne, D.; Truesdale, A.; The UK and Ireland Liver Transplant Study Group (2002). "Tacrolimus versus microemulsified ciclosporin in liver transplantation: the TMC randomised controlled trial". <i>Lancet</i>. <b>360</b> (9340): 1119–1125. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FS0140-6736%2802%2911196-2">10.1016/S0140-6736(02)11196-2</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12387959">12387959</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:10417106">10417106</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Lancet&rft.atitle=Tacrolimus+versus+microemulsified+ciclosporin+in+liver+transplantation%3A+the+TMC+randomised+controlled+trial&rft.volume=360&rft.issue=9340&rft.pages=1119-1125&rft.date=2002&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A10417106%23id-name%3DS2CID&rft_id=info%3Apmid%2F12387959&rft_id=info%3Adoi%2F10.1016%2FS0140-6736%2802%2911196-2&rft.aulast=O%27Grady&rft.aufirst=J.+G.&rft.au=Burroughs%2C+A.&rft.au=Hardy%2C+P.&rft.au=Elbourne%2C+D.&rft.au=Truesdale%2C+A.&rft.au=The+UK+and+Ireland+Liver+Transplant+Study+Group&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALiver+transplantation" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFUmeshitaFujiwaraKiyosawaMakuuchi2003" class="citation journal cs1">Umeshita, K.; Fujiwara, K.; Kiyosawa, K.; Makuuchi, M.; Satomi, S.; Sugimachi, K.; Tanaka, K.; Monden, M.; Japanese Liver Transplantation Society (2003). 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"Evolution of liver transplantation in Europe: report of the European Liver Transplant Registry". <i>Liver Transpl</i>. <b>9</b> (12): 1231–43. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.lts.2003.09.018">10.1016/j.lts.2003.09.018</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/14625822">14625822</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:22244161">22244161</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Liver+Transpl&rft.atitle=Evolution+of+liver+transplantation+in+Europe%3A+report+of+the+European+Liver+Transplant+Registry&rft.volume=9&rft.issue=12&rft.pages=1231-43&rft.date=2003&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A22244161%23id-name%3DS2CID&rft_id=info%3Apmid%2F14625822&rft_id=info%3Adoi%2F10.1016%2Fj.lts.2003.09.018&rft.aulast=Adam&rft.aufirst=R&rft.au=McMaster%2C+P&rft.au=O%27Grady%2C+JG&rft.au=Castaing%2C+D&rft.au=Klempnauer%2C+JL&rft.au=Jamieson%2C+N&rft.au=Neuhaus%2C+P&rft.au=Lerut%2C+J&rft.au=Salizzoni%2C+M&rft.au=Pollard%2C+S&rft.au=Muhlbacher%2C+F&rft.au=Rogiers%2C+X&rft.au=Garcia+Valdecasas%2C+JC&rft.au=Berenguer%2C+J&rft.au=Jaeck%2C+D&rft.au=Moreno+Gonzalez%2C+E&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALiver+transplantation" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFEghtesadKadryFung2005" class="citation journal cs1">Eghtesad B, Kadry Z, Fung J (2005). "Technical considerations in liver transplantation: what a hepatologist needs to know (and every surgeon should practice)". <i>Liver Transpl</i>. <b>11</b> (8): 861–71. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Flt.20529">10.1002/lt.20529</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16035067">16035067</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:29715791">29715791</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Liver+Transpl&rft.atitle=Technical+considerations+in+liver+transplantation%3A+what+a+hepatologist+needs+to+know+%28and+every+surgeon+should+practice%29&rft.volume=11&rft.issue=8&rft.pages=861-71&rft.date=2005&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A29715791%23id-name%3DS2CID&rft_id=info%3Apmid%2F16035067&rft_id=info%3Adoi%2F10.1002%2Flt.20529&rft.aulast=Eghtesad&rft.aufirst=B&rft.au=Kadry%2C+Z&rft.au=Fung%2C+J&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALiver+transplantation" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFFan_ST2006" class="citation journal cs1">Fan ST (2006). <a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F01.tp.0000235171.17287.f2">"Live donor liver transplantation in adults"</a>. <i>Transplantation</i>. <b>82</b> (6): 723–32. <a 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title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Int+J+Med+Sci&rft.atitle=Antiviral+therapy+of+HCV+in+the+cirrhotic+and+transplant+candidate&rft.volume=3&rft.issue=2&rft.pages=75-8&rft.date=2006&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1415848%23id-name%3DPMC&rft_id=info%3Apmid%2F16614747&rft_id=info%3Adoi%2F10.7150%2Fijms.3.75&rft.aulast=Herrine&rft.aufirst=SK&rft.au=Navarro%2C+VJ&rft_id=http%3A%2F%2Fwww.medsci.org%2Fv03p0075.htm&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALiver+transplantation" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKrahnDiMartini2005" class="citation journal cs1">Krahn LE, DiMartini A (2005). <a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Flt.20578">"Psychiatric and psychosocial aspects of liver transplantation"</a>. <i>Liver Transpl</i>. <b>11</b> (10): 1157–68. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Flt.20578">10.1002/lt.20578</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16184540">16184540</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:19940371">19940371</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Liver+Transpl&rft.atitle=Psychiatric+and+psychosocial+aspects+of+liver+transplantation&rft.volume=11&rft.issue=10&rft.pages=1157-68&rft.date=2005&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A19940371%23id-name%3DS2CID&rft_id=info%3Apmid%2F16184540&rft_id=info%3Adoi%2F10.1002%2Flt.20578&rft.aulast=Krahn&rft.aufirst=LE&rft.au=DiMartini%2C+A&rft_id=https%3A%2F%2Fdoi.org%2F10.1002%252Flt.20578&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALiver+transplantation" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMartinezRosen2005" class="citation journal cs1">Martinez OM, Rosen HR (2005). 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"The current status of living donor liver transplantation". <i>Curr Probl Surg</i>. <b>42</b> (3): 144–83. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1067%2Fj.cpsurg.2004.12.003">10.1067/j.cpsurg.2004.12.003</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15859440">15859440</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Curr+Probl+Surg&rft.atitle=The+current+status+of+living+donor+liver+transplantation&rft.volume=42&rft.issue=3&rft.pages=144-83&rft.date=2005&rft_id=info%3Adoi%2F10.1067%2Fj.cpsurg.2004.12.003&rft_id=info%3Apmid%2F15859440&rft.aulast=Tuttle-Newhall&rft.aufirst=JE&rft.au=Collins%2C+BH&rft.au=Desai%2C+DM&rft.au=Kuo%2C+PC&rft.au=Heneghan%2C+MA&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALiver+transplantation" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFVierling_JM2005" class="citation journal cs1">Vierling JM (2005). <a rel="nofollow" class="external text" href="http://www.medsci.org/v02p0041.htm">"Management of HBV Infection in Liver Transplantation Patients"</a>. <i>Int J Med Sci</i>. <b>2</b> (1): 41–49. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.7150%2Fijms.2.41">10.7150/ijms.2.41</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1142224">1142224</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15968339">15968339</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Int+J+Med+Sci&rft.atitle=Management+of+HBV+Infection+in+Liver+Transplantation+Patients&rft.volume=2&rft.issue=1&rft.pages=41-49&rft.date=2005&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1142224%23id-name%3DPMC&rft_id=info%3Apmid%2F15968339&rft_id=info%3Adoi%2F10.7150%2Fijms.2.41&rft.au=Vierling+JM&rft_id=http%3A%2F%2Fwww.medsci.org%2Fv02p0041.htm&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALiver+transplantation" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFVohra_V2006" class="citation journal cs1">Vohra V (2006). "Liver transplantation in India". <i>Int Anesthesiol Clin</i>. <b>44</b> (4): 137–49. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F01.aia.0000210810.77663.57">10.1097/01.aia.0000210810.77663.57</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17033486">17033486</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:2526328">2526328</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Int+Anesthesiol+Clin.&rft.atitle=Liver+transplantation+in+India&rft.volume=44&rft.issue=4&rft.pages=137-49&rft.date=2006&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A2526328%23id-name%3DS2CID&rft_id=info%3Apmid%2F17033486&rft_id=info%3Adoi%2F10.1097%2F01.aia.0000210810.77663.57&rft.au=Vohra+V&rfr_id=info%3Asid%2Fen.wikipedia.org%3ALiver+transplantation" class="Z3988"></span></li></ul> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Liver_transplantation&action=edit&section=30" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a rel="nofollow" class="external text" href="https://unos.org/">UNOS: United Network of Organ Sharing, U.S.</a></li> <li><a rel="nofollow" class="external text" href="https://liverfoundation.org/">American Liver Foundation</a></li> <li><a rel="nofollow" class="external text" href="https://emedicine.medscape.com/article/1012910-overview">History of pediatric liver transplantation</a></li> <li><a rel="nofollow" class="external text" href="https://www.mountsinai.org/care/transplant/services/living-donor/liver-surgery-recovery">Liver Donation Surgery and Recovery</a></li> <li><a rel="nofollow" class="external text" href="https://www.livertransplantindia.com/liver-transplant.asp">Facts about Liver Transplantation</a></li> <li><a rel="nofollow" class="external text" href="https://childliverdisease.org/liver-information/transplant/">Children's Liver Disease Foundation</a></li> <li><a rel="nofollow" class="external text" href="https://pie.med.utoronto.ca/TVASurg/project/transplant-rightheprecip/">The Toronto Video Atlas of Liver, Pancreas and Transplant Surgery – Living Donor Right Lobe Liver Transplant video (recipient)</a></li> <li><a rel="nofollow" class="external text" href="https://pie.med.utoronto.ca/TVASurg/project/transplant-leftlateraldonor/">The Toronto Video Atlas of Liver, Pancreas and Transplant Surgery – Living Donor Left Lateral Lobe Liver Transplant video (donor)</a></li> <li><a rel="nofollow" class="external text" href="https://pie.med.utoronto.ca/TVASurg/project/transplant-rightpostdonor/">The Toronto Video Atlas of Liver, Pancreas and Transplant Surgery – Living Donor Right Posterior Sectionectomy (Segments 6/7) Liver Transplant video (donor)</a></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output 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li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist li::after{content:" · ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q1368191" class="extiw" title="d:Q1368191">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D016031">D016031</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a></b>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/Liver-Transplantation">Liver transplantation</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Organ_transplantation" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Organ_transplantation" title="Template:Organ transplantation"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Organ_transplantation" title="Template talk:Organ transplantation"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Organ_transplantation" title="Special:EditPage/Template:Organ transplantation"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Organ_transplantation" style="font-size:114%;margin:0 4em"><a href="/wiki/Organ_transplantation" title="Organ transplantation">Organ transplantation</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Types</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Allotransplantation" title="Allotransplantation">Allotransplantation</a> <ul><li><a href="/wiki/ABO-incompatible_transplantation" title="ABO-incompatible transplantation">ABOi</a></li></ul></li> <li><a href="/wiki/Autotransplantation" title="Autotransplantation">Autotransplantation</a></li> <li><a href="/wiki/Xenotransplantation" title="Xenotransplantation">Xenotransplantation</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Transplantable_organs_and_tissues" title="Transplantable organs and tissues">Organs and tissues</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bone_grafting" title="Bone grafting">Bone</a></li> <li><a href="/wiki/Hematopoietic_stem_cell_transplantation" title="Hematopoietic stem cell transplantation">Bone marrow</a></li> <li><a href="/wiki/Brain_transplant" title="Brain transplant">Brain</a></li> <li><a href="/wiki/Corneal_transplantation" title="Corneal transplantation">Corneal</a></li> <li><a href="/wiki/Eye_transplantation" title="Eye transplantation">Eye</a></li> <li><a href="/wiki/Face_transplant" title="Face transplant">Face</a></li> <li><a href="/wiki/Hand_transplantation" title="Hand transplantation">Hand</a></li> <li><a href="/wiki/Head_transplant" title="Head transplant">Head</a></li> <li><a href="/wiki/Heart_transplantation" title="Heart transplantation">Heart</a></li> <li><a href="/wiki/Heart%E2%80%93lung_transplant" title="Heart–lung transplant">Heart–lung</a></li> <li><a href="/wiki/Intestine_transplantation" title="Intestine transplantation">Intestine</a></li> <li><a href="/wiki/Kidney_transplantation" title="Kidney transplantation">Kidney</a></li> <li><a class="mw-selflink selflink">Liver</a></li> <li><a href="/wiki/Lung_transplantation" title="Lung transplantation">Lung</a></li> <li><a href="/wiki/Pancreas_transplantation" title="Pancreas transplantation">Pancreas</a> <ul><li><a href="/wiki/Islet_cell_transplantation" title="Islet cell transplantation">islet cell</a></li></ul></li> <li><a href="/wiki/Penis_transplantation" title="Penis transplantation">Penis</a></li> <li><a href="/wiki/Skin_grafting" title="Skin grafting">Skin</a></li> <li><a href="/wiki/Spleen_transplantation" title="Spleen transplantation">Spleen</a></li> <li><a href="/wiki/Thymus_transplantation" title="Thymus transplantation">Thymus</a></li> <li><a href="/wiki/Uterus_transplantation" title="Uterus transplantation">Uterus</a></li> <li><a href="/wiki/Vaginal_transplantation" title="Vaginal transplantation">Vagina</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Graft_(surgery)" title="Graft (surgery)">Medical grafting</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bone_grafting" title="Bone grafting">Bone grafting</a></li> <li><a href="/wiki/Skin_grafting" title="Skin grafting">Skin grafting</a></li> <li><a href="/wiki/Vascular_bypass" title="Vascular bypass">Vascular bypass</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Organ_donation" title="Organ donation">Organ donation</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Non-heart-beating_donation" title="Non-heart-beating donation">Non-heart-beating donation</a></li> <li><a href="/wiki/Organ_procurement" title="Organ procurement">Organ procurement</a></li> <li><a href="/wiki/Organ_trade" title="Organ trade">Organ trade</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Complications</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Graft-versus-host_disease" title="Graft-versus-host disease">Graft-versus-host disease</a></li> <li><a href="/wiki/Post-transplant_lymphoproliferative_disorder" title="Post-transplant lymphoproliferative disorder">Post-transplant lymphoproliferative disorder</a></li> <li><a href="/wiki/Transplant_rejection" title="Transplant rejection">Transplant rejection</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Transplant networks<br />and government<br /> departments</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Eurotransplant" title="Eurotransplant">Eurotransplant</a></li> <li><a href="/wiki/Gift_of_Life_Marrow_Registry" title="Gift of Life Marrow Registry">Gift of Life Marrow Registry</a></li> <li><a href="/wiki/Human_Tissue_Authority" title="Human Tissue Authority">Human Tissue Authority</a></li> <li><a href="/wiki/LifeSharers" title="LifeSharers">LifeSharers</a></li> <li><a href="/wiki/National_Marrow_Donor_Program" title="National Marrow Donor Program">National Marrow Donor Program</a></li> <li><a href="/wiki/National_Organization_for_Organ_and_Tissues_Donation_and_Transplantation_(Lebanon)" title="National Organization for Organ and Tissues Donation and Transplantation (Lebanon)">NOD-Lb</a></li> <li><a href="/wiki/National_Transplant_Organization" title="National Transplant Organization">National Transplant Organization</a></li> <li><a href="/wiki/NHS_Blood_and_Transplant" title="NHS Blood and Transplant">NHS Blood and Transplant</a></li> <li><a href="/wiki/Trillium_Gift_of_Life_Network" title="Trillium Gift of Life Network">Trillium Gift of Life Network</a></li> <li><a href="/wiki/United_Network_for_Organ_Sharing" title="United Network for Organ Sharing">United Network for Organ Sharing</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Advocacy<br /> organizations</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anthony_Nolan" title="Anthony Nolan">Anthony Nolan</a></li> <li><a href="/wiki/Blood_Cancer_UK" title="Blood Cancer UK">Blood Cancer UK</a></li> <li><a href="/wiki/DKMS" title="DKMS">DKMS</a></li> <li><a href="/wiki/Halachic_Organ_Donor_Society" title="Halachic Organ Donor Society">Halachic Organ Donor Society</a></li> <li><a href="/wiki/Kidney_Foundation_of_Canada" title="Kidney Foundation of Canada">Kidney Foundation of Canada</a></li> <li><a href="/wiki/National_Kidney_Foundation" title="National Kidney Foundation">National Kidney Foundation</a></li> <li><a href="/wiki/ORGANIZE" title="ORGANIZE">ORGANIZE</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Joint societies</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/American_Society_of_Nephrology" title="American Society of Nephrology">American Society of Nephrology</a></li> <li><a href="/wiki/American_Society_of_Transplantation" title="American Society of Transplantation">American Society of Transplantation</a></li> <li><a href="/wiki/Canadian_Society_of_Transplantation" title="Canadian Society of Transplantation">Canadian Society of Transplantation</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Countries</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Organ_transplantation_in_China" title="Organ transplantation in China">Organ transplantation in China</a> <ul><li><a href="/wiki/Organ_harvesting_from_Falun_Gong_practitioners_in_China" title="Organ harvesting from Falun Gong practitioners in China">harvesting from Falun Gong</a></li></ul></li> <li><a href="/wiki/Organ_donation_in_India" title="Organ donation in India">Organ donation in India</a> <ul><li><a href="/wiki/Gurgaon_kidney_scandal" title="Gurgaon kidney scandal">Gurgaon kidney scandal</a></li></ul></li> <li><a href="/wiki/Organ_transplantation_in_Israel" title="Organ transplantation in Israel">Organ transplantation in Israel</a></li> <li><a href="/wiki/Organ_transplantation_in_Japan" title="Organ transplantation in Japan">Organ transplantation in Japan</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">People</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Heart</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Christiaan_Barnard" title="Christiaan Barnard">Christiaan Barnard</a></li> <li><a href="/wiki/James_Hardy_(surgeon)" title="James Hardy (surgeon)"> James D. Hardy</a></li> <li><a href="/wiki/Adrian_Kantrowitz" title="Adrian Kantrowitz">Adrian Kantrowitz</a></li> <li><a href="/wiki/Richard_Lower_(surgeon)" title="Richard Lower (surgeon)">Richard Lower</a></li> <li><a href="/wiki/Norman_Shumway" title="Norman Shumway">Norman Shumway</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Kidney</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/J._Hartwell_Harrison" title="J. Hartwell Harrison">J. Hartwell Harrison</a></li> <li><a href="/wiki/John_P._Merrill" title="John P. Merrill">John P. Merrill</a></li> <li><a href="/wiki/Joseph_Murray" class="mw-redirect" title="Joseph Murray">Joseph Murray</a></li> <li><a href="/wiki/Elizabeth_Ward_(British_campaigner)" title="Elizabeth Ward (British campaigner)">Elizabeth Ward</a></li> <li><a href="/wiki/Michael_Woodruff" title="Michael Woodruff">Michael Woodruff</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Liver</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fikri_Alican" title="Fikri Alican">Fikri Alican</a></li> <li><a href="/wiki/James_Hardy_(surgeon)" title="James Hardy (surgeon)"> James D. Hardy</a></li> <li><a href="/wiki/Thomas_Starzl" title="Thomas Starzl">Thomas Starzl</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Lung</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fikri_Alican" title="Fikri Alican">Fikri Alican</a></li> <li><a href="/wiki/Joel_D._Cooper" title="Joel D. Cooper">Joel D. Cooper</a></li> <li><a href="/wiki/Vladimir_Demikhov" title="Vladimir Demikhov">Vladimir Demikhov</a></li> <li><a href="/wiki/James_Hardy_(surgeon)" title="James Hardy (surgeon)"> James D. Hardy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Pancreas</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Richard_C._Lillehei" title="Richard C. Lillehei">Richard C. Lillehei</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Penis</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Andr%C3%A9_van_der_Merwe" title="André van der Merwe">André van der Merwe</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alexis_Carrel" title="Alexis Carrel">Alexis Carrel</a></li> <li><a href="/wiki/Jean-Michel_Dubernard" title="Jean-Michel Dubernard">Jean-Michel Dubernard</a></li> <li><a href="/wiki/Donna_Mansell" title="Donna Mansell">Donna Mansell</a></li> <li><a href="/wiki/Bruce_Reitz" title="Bruce Reitz">Bruce Reitz</a></li></ul> </div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/List_of_organ_transplant_donors_and_recipients" title="List of organ transplant donors and recipients">List of organ transplant donors and recipients</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related topics</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Biomedical_tissue" title="Biomedical tissue">Biomedical tissue</a></li> <li><a href="/wiki/Edmonton_protocol" title="Edmonton protocol">Edmonton protocol</a></li> <li><a href="/wiki/Eye_bank" title="Eye bank">Eye bank</a></li> <li><a href="/wiki/Immunosuppressive_drug" title="Immunosuppressive drug">Immunosuppressive drugs</a></li> <li><a href="/wiki/Lung_allocation_score" title="Lung allocation score">Lung allocation score</a></li> <li><a href="/wiki/Machine_perfusion" title="Machine perfusion">Machine perfusion</a></li> <li><a href="/wiki/Total_body_irradiation" title="Total body irradiation">Total body irradiation</a></li> <li><a href="/wiki/Frankenstein%27s_monster" title="Frankenstein's monster">Frankenstein's monster</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Tests_and_procedures_involving_the_human_digestive_system" style="padding:3px"><table class="nowraplinks hlist mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Digestive_system_procedures" title="Template:Digestive system procedures"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Digestive_system_procedures" title="Template talk:Digestive system procedures"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Digestive_system_procedures" title="Special:EditPage/Template:Digestive system procedures"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Tests_and_procedures_involving_the_human_digestive_system" style="font-size:114%;margin:0 4em">Tests and procedures involving the <a href="/wiki/Human_digestive_system" title="Human digestive system">human digestive system</a></div></th></tr><tr><td class="navbox-abovebelow" colspan="2"><div><a href="/wiki/Digestive_system_surgery" title="Digestive system surgery">Digestive system surgery</a></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_gastrointestinal_tract" class="mw-redirect" title="Human gastrointestinal tract">Digestive tract</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Upper_GI_tract" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_gastrointestinal_tract#Upper_gastrointestinal_tract" class="mw-redirect" title="Human gastrointestinal tract">Upper GI tract</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Salivary_gland" title="Salivary gland">SGs</a> / <a href="/wiki/Esophagus" title="Esophagus">Esophagus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Esophagectomy" title="Esophagectomy">Esophagectomy</a></li> <li><a href="/wiki/Heller_myotomy" title="Heller myotomy">Heller myotomy</a></li> <li><a href="/wiki/Sialography" title="Sialography">Sialography</a></li> <li><a href="/wiki/Impedance%E2%80%93pH_monitoring" title="Impedance–pH monitoring">Impedance–pH monitoring</a></li> <li><a href="/wiki/Esophageal_pH_monitoring" title="Esophageal pH monitoring">Esophageal pH monitoring</a></li> <li><a href="/wiki/Esophageal_motility_study" title="Esophageal motility study">Esophageal motility study</a></li> <li><a href="/wiki/Functional_Lumen_Imaging_Probe" title="Functional Lumen Imaging Probe">Functional Lumen Imaging Probe</a></li> <li><a href="/wiki/High_resolution_manometry" class="mw-redirect" title="High resolution manometry">High resolution manometry</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Stomach" title="Stomach">Stomach</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Sengstaken%E2%80%93Blakemore_tube" title="Sengstaken–Blakemore tube">Sengstaken–Blakemore tube</a>)</li> <li><a href="/wiki/Nasogastric_tube" class="mw-redirect" title="Nasogastric tube">Nasogastric tube</a></li> <li><a href="/wiki/Gastric_lavage" title="Gastric lavage">Gastric lavage</a></li> <li><a href="/wiki/Bariatric_surgery" title="Bariatric surgery">Bariatric surgery</a> <ul><li><a href="/wiki/Adjustable_gastric_band" title="Adjustable gastric band">Adjustable gastric band</a></li> <li><a href="/wiki/Endoscopic_sleeve_gastroplasty" title="Endoscopic sleeve gastroplasty">Endoscopic sleeve gastroplasty</a></li> <li><a href="/wiki/Gastric_bypass_surgery" title="Gastric bypass surgery">Gastric bypass surgery</a></li> <li><a href="/wiki/Sleeve_gastrectomy" title="Sleeve gastrectomy">Sleeve gastrectomy</a></li> <li><a href="/wiki/Vertical_banded_gastroplasty_surgery" title="Vertical banded gastroplasty surgery">Vertical banded gastroplasty surgery</a></li></ul></li> <li><a href="/wiki/Collis_gastroplasty" title="Collis gastroplasty">Collis gastroplasty</a></li> <li><a href="/wiki/Gastrectomy" title="Gastrectomy">Gastrectomy</a> <ul><li><a href="/wiki/Billroth_I" title="Billroth I">Billroth I</a></li> <li><a href="/wiki/Billroth_II" title="Billroth II">Billroth II</a></li> <li><a href="/wiki/Roux-en-Y_anastomosis" title="Roux-en-Y anastomosis">Roux-en-Y</a></li></ul></li> <li><a href="/wiki/Gastroenterostomy" title="Gastroenterostomy">Gastroenterostomy</a></li> <li><a href="/wiki/Gastropexy" title="Gastropexy">Gastropexy</a></li> <li><a href="/wiki/Gastrostomy" title="Gastrostomy">Gastrostomy</a> <ul><li><a href="/wiki/Percutaneous_endoscopic_gastrostomy" title="Percutaneous endoscopic gastrostomy">Percutaneous endoscopic gastrostomy</a></li></ul></li> <li><a href="/wiki/Esophagogastric_dissociation" title="Esophagogastric dissociation">Esophagogastric dissociation</a></li> <li><a href="/wiki/Hill_repair" title="Hill repair">Hill repair</a></li> <li><a href="/wiki/Nissen_fundoplication" title="Nissen fundoplication">Nissen fundoplication</a></li> <li><a href="/wiki/Pyloromyotomy" title="Pyloromyotomy">Pyloromyotomy</a></li> <li><a href="/wiki/Schilling_test" title="Schilling test">Schilling test</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Medical_imaging" title="Medical imaging">Medical imaging</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Endoscopy" title="Endoscopy">Endoscopy</a> <ul><li><a href="/wiki/Esophagogastroduodenoscopy" title="Esophagogastroduodenoscopy">Esophagogastroduodenoscopy</a></li></ul></li> <li><a href="/wiki/Barium_swallow" class="mw-redirect" title="Barium swallow">Barium swallow</a></li> <li><a href="/wiki/Upper_gastrointestinal_series" title="Upper gastrointestinal series">Upper gastrointestinal series</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_gastrointestinal_tract#Lower_gastrointestinal_tract" class="mw-redirect" title="Human gastrointestinal tract">Lower GI tract</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Small_bowel" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Small_intestine" title="Small intestine">Small bowel</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bariatric_surgery" title="Bariatric surgery">Bariatric surgery</a> <ul><li><a href="/wiki/Duodenal_switch" title="Duodenal switch">Duodenal switch</a></li> <li><a href="/wiki/Jejunoileal_bypass" title="Jejunoileal bypass">Jejunoileal bypass</a></li></ul></li> <li><a href="/wiki/Bowel_resection" title="Bowel resection">Bowel resection</a></li> <li><a href="/wiki/Ileostomy" title="Ileostomy">Ileostomy</a></li> <li><a href="/wiki/Intestine_transplantation" title="Intestine transplantation">Intestine transplantation</a></li> <li><a href="/wiki/Jejunostomy" title="Jejunostomy">Jejunostomy</a></li> <li><a href="/wiki/Partial_ileal_bypass_surgery" title="Partial ileal bypass surgery">Partial ileal bypass surgery</a></li> <li><a href="/wiki/Strictureplasty" title="Strictureplasty">Strictureplasty</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Colon_(anatomy)" class="mw-redirect" title="Colon (anatomy)">Large bowel</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Appendectomy" title="Appendectomy">Appendectomy</a></li> <li><a href="/wiki/Colectomy" title="Colectomy">Colectomy</a></li> <li><a href="/wiki/Colonic_polypectomy" title="Colonic polypectomy">Colonic polypectomy</a></li> <li><a href="/wiki/Colostomy" title="Colostomy">Colostomy</a></li> <li><a href="/wiki/Hartmann%27s_operation" title="Hartmann's operation">Hartmann's operation</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Rectum" title="Rectum">Rectum</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Abdominoperineal_resection" title="Abdominoperineal resection">Abdominoperineal resection</a></li> <li><a href="/wiki/Lower_anterior_resection" title="Lower anterior resection">Lower anterior resection</a></li> <li><a href="/wiki/Total_mesorectal_excision" title="Total mesorectal excision">Total mesorectal excision</a></li> <li><a href="/wiki/Ventral_rectopexy" title="Ventral rectopexy">Ventral rectopexy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anal_canal" title="Anal canal">Anal canal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anal_sphincterotomy" title="Anal sphincterotomy">Anal sphincterotomy</a></li> <li><a href="/wiki/Anorectal_manometry" title="Anorectal manometry">Anorectal manometry</a></li> <li><a href="/wiki/Lateral_internal_sphincterotomy" title="Lateral internal sphincterotomy">Lateral internal sphincterotomy</a></li> <li><a href="/wiki/Rubber_band_ligation" title="Rubber band ligation">Rubber band ligation</a></li> <li><a href="/wiki/Transanal_hemorrhoidal_dearterialization" title="Transanal hemorrhoidal dearterialization">Transanal hemorrhoidal dearterialization</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Medical_imaging" title="Medical imaging">Medical imaging</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Endoscopy" title="Endoscopy">Endoscopy</a>: <a href="/wiki/Colonoscopy" title="Colonoscopy">Colonoscopy</a></li> <li><a href="/wiki/Anoscopy" title="Anoscopy">Anoscopy</a></li> <li><a href="/wiki/Capsule_endoscopy" title="Capsule endoscopy">Capsule endoscopy</a></li> <li><a href="/wiki/Enteroscopy" title="Enteroscopy">Enteroscopy</a></li> <li><a href="/wiki/Proctoscopy" title="Proctoscopy">Proctoscopy</a></li> <li><a href="/wiki/Sigmoidoscopy" title="Sigmoidoscopy">Sigmoidoscopy</a></li></ul> <ul><li><a href="/wiki/Abdominal_ultrasonography" title="Abdominal ultrasonography">Abdominal ultrasonography</a></li> <li><a href="/wiki/Defecography" title="Defecography">Defecography</a></li> <li><a href="/wiki/Double-contrast_barium_enema" title="Double-contrast barium enema">Double-contrast barium enema</a></li> <li><a href="/wiki/Endoanal_ultrasound" title="Endoanal ultrasound">Endoanal ultrasound</a></li> <li><a href="/wiki/Enteroclysis" class="mw-redirect" title="Enteroclysis">Enteroclysis</a></li> <li><a href="/wiki/Lower_gastrointestinal_series" title="Lower gastrointestinal series">Lower gastrointestinal series</a></li> <li><a href="/wiki/Small-bowel_follow-through" class="mw-redirect" title="Small-bowel follow-through">Small-bowel follow-through</a></li> <li><a href="/wiki/Transrectal_ultrasonography" title="Transrectal ultrasonography">Transrectal ultrasonography</a></li> <li><a href="/wiki/Virtual_colonoscopy" title="Virtual colonoscopy">Virtual colonoscopy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Stool_test" title="Stool test">Stool tests</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fecal_fat_test" title="Fecal fat test">Fecal fat test</a></li> <li><a href="/wiki/Fecal_pH_test" title="Fecal pH test">Fecal pH test</a></li> <li><a href="/wiki/Stool_guaiac_test" title="Stool guaiac test">Stool guaiac test</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Accessory_digestive_gland" class="mw-redirect" title="Accessory digestive gland">Accessory</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Liver" title="Liver">Liver</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Artificial_extracorporeal_liver_support" class="mw-redirect" title="Artificial extracorporeal liver support">Artificial extracorporeal liver support</a> <ul><li><a href="/wiki/Bioartificial_liver_device" class="mw-redirect" title="Bioartificial liver device">Bioartificial liver devices</a></li> <li><a href="/wiki/Liver_dialysis" class="mw-redirect" title="Liver dialysis">Liver dialysis</a></li></ul></li> <li><a href="/wiki/Hepatectomy" title="Hepatectomy">Hepatectomy</a></li> <li><a href="/wiki/Liver_biopsy" title="Liver biopsy">Liver biopsy</a></li> <li><a class="mw-selflink selflink">Liver transplantation</a></li> <li><a href="/wiki/Portal_hypertension" title="Portal hypertension">Portal hypertension</a> <ul><li><a href="/wiki/Transjugular_intrahepatic_portosystemic_shunt" title="Transjugular intrahepatic portosystemic shunt">Transjugular intrahepatic portosystemic shunt</a> [TIPS]</li> <li><a href="/wiki/Distal_splenorenal_shunt_procedure" title="Distal splenorenal shunt procedure">Distal splenorenal shunt procedure</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gallbladder" title="Gallbladder">Gallbladder</a>, <a href="/wiki/Bile_duct" title="Bile duct">bile duct</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cholecystectomy" title="Cholecystectomy">Cholecystectomy</a></li> <li><a href="/wiki/Cholecystostomy" title="Cholecystostomy">Cholecystostomy</a></li> <li><a href="/wiki/Endoscopic_retrograde_cholangiopancreatography" title="Endoscopic retrograde cholangiopancreatography">ERCP</a></li> <li><a href="/wiki/Hepatoportoenterostomy" title="Hepatoportoenterostomy">Hepatoportoenterostomy</a></li></ul> <ul><li><a href="/wiki/Medical_imaging" title="Medical imaging">Medical imaging</a>: <a href="/wiki/Cholangiography" title="Cholangiography">Cholangiography</a> <ul><li><a href="/wiki/Intravenous_cholangiography" title="Intravenous cholangiography">IV</a></li> <li><a href="/wiki/Magnetic_resonance_cholangiopancreatography" title="Magnetic resonance cholangiopancreatography">MRCP</a></li> <li><a href="/wiki/Percutaneous_transhepatic_cholangiography" title="Percutaneous transhepatic cholangiography">PTC</a></li></ul></li> <li><a href="/wiki/Cholecystography" title="Cholecystography">Cholecystography</a></li> <li><a href="/wiki/Cholescintigraphy" title="Cholescintigraphy">Cholescintigraphy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pancreas" title="Pancreas">Pancreas</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Frey%27s_procedure" title="Frey's procedure">Frey's procedure</a></li> <li><a href="/wiki/Pancreas_transplantation" title="Pancreas transplantation">Pancreas transplantation</a></li> <li><a href="/wiki/Pancreatectomy" title="Pancreatectomy">Pancreatectomy</a></li> <li><a href="/wiki/Pancreaticoduodenectomy" title="Pancreaticoduodenectomy">Pancreaticoduodenectomy</a></li> <li><a href="/wiki/Puestow_procedure" title="Puestow procedure">Puestow procedure</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Abdominopelvic_cavity" title="Abdominopelvic cavity">Abdominopelvic</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Peritoneum" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Peritoneum" title="Peritoneum">Peritoneum</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Diagnostic_peritoneal_lavage" title="Diagnostic peritoneal lavage">Diagnostic peritoneal lavage</a></li> <li><a href="/wiki/Intraperitoneal_injection" title="Intraperitoneal injection">Intraperitoneal injection</a></li> <li><a href="/wiki/Laparoscopy" title="Laparoscopy">Laparoscopy</a></li> <li><a href="/wiki/Omentopexy" title="Omentopexy">Omentopexy</a></li> <li><a href="/wiki/Paracentesis" title="Paracentesis">Paracentesis</a></li> <li><a href="/wiki/Peritoneal_dialysis" title="Peritoneal dialysis">Peritoneal dialysis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hernia" title="Hernia">Hernia</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hernia_repair" title="Hernia repair">Hernia repair</a></li> <li><a href="/wiki/Inguinal_hernia_surgery" title="Inguinal hernia surgery">Inguinal hernia surgery</a></li> <li><a href="/wiki/Femoral_hernia_repair" class="mw-redirect" title="Femoral hernia repair">Femoral hernia repair</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Laparotomy" title="Laparotomy">Laparotomy</a> <ul><li><a href="/wiki/Exploratory_laparotomy" title="Exploratory laparotomy">Exploratory laparotomy</a></li></ul></li> <li><a href="/wiki/Rapid_urease_test" title="Rapid urease test">Rapid urease test</a> / <a href="/wiki/Urea_breath_test" title="Urea breath test">Urea breath test</a></li></ul> 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