Liver transplantation in the UK

Introduction: This paper provides a review of the practice of liver transpl antation with the main emphasis on UK practice and indications for transpla ntation. Referral and Assessment: This section reviews the process of referral and a ssessment of patients with liver disease with reference to UK practice. Donor Organs: The practice of brainstem death and cadaveric organ donation is peculiar to individual countries and rates of donation and potential are as of improvement are addressed. Operative Technique: The technical innovations that have led to liver trans plantation becoming a semi-elective procedure are reviewed. Specific emphas is is made to the role of liver reduction and splitting and living related liver transplantation and how this impacts on UK practice are reviewed. The complications of liver transplantation are also reviewed with reference to our own unit. Immunosuppression: The evolution of immunosuppression and its impact on liv er transplantation are reviewed with some reference to future protocols. Re transplantation: The role of retransplantation is reviewed. Outcome and Survival: The results of liver transplantation are reviewed wit h specific emphasis on our own experience. Future: The future of liver transplantation is addressed.