THE NEED FOR LIVER-TRANSPLANTATION - A NATIONWIDE ESTIMATE BASED ON CONSENSUS REVIEW

Orthotopic liver transplantation (OLT) is widely practised in develope d countries. The procedure is costly, the supply of donor organs limit ed, and it is not known how many patients need transplantation. A comm unity-wide estimate of the needs for OLT was performed over two years in all general hospitals in Israel. Records of 1851 patients with live r disease were screened to identify those who might eventually need OL T. The annual estimate of transplantation needs in the country was 10- 15.5 per million population, with equal numbers of males and females. The addition of patients with non-reformed alcoholism and end-stage li ver disease, originally set as an exclusion criteria, would have added 20% to this estimate. 37% of potential candidates were under 40 years of age at diagnosis, and about 50% were 55-64 years old. Almost 80% o f patients had cirrhosis of the liver and 13.6% had fulminant hepatiti s. These findings provide a basis for a national plan of OLT in Israel , and similar studies might be useful in other countries.