Liver transplantation indications

Improvements in surgical techniques associated with immunosuppressive treatment and prevention of complications have made effective liver transplant.

This is actually the only method of hepatic functional replacement.

A liver transplant may be considered:

1 - To mitigate global liver failure, the result of chronic liver disease. It may be acquired or congenital liver disease, cholestatic or non-toxic or not (alcohol, cirrhosis).

2 - To address acute liver creating a severe acute liver failure:

- HEPATITIS FULMINANT,

- VIRAL HEPATITIS (see these terms)

- Toxic hepatitis,

- HEPATITIS AUTO IMMUNE or metabolic.

3 - More exception to address a specific enzyme deficiency and prevent extrahepatic complications congenital familial jaundice and Crigler Najjar, deficiency of urea cycle, oxalosis deficiency of certain clotting factors.

4. Finally, in the case of a primary or secondary liver tumors, to replace the liver after total hepatectomy.

Factors limiting liver transplantation are:

- The risk of disease recurrence in the graft (in cases of viral hepatitis, for example)

- The quality of outcomes and quality of life after transplantation.

In practice, the transplants in 1996 were the causes:

- 19% for post-viral cirrhosis (6% for hepatitis B, 13% for hepatitis C)

- 2% for an autoimmune cirrhosis

- 24% for alcoholic cirrhosis weaned,

- 5% for biliary cirrhosis,

- 4% for cirrhosis of other causes,

- 7% fulminant hepatitis,

- 9% liver tumor,