Home > Health A – Z > Liver Transplantation

Liver Transplantation

Replacement of a person's liver with that of another person, used to treat end stage liver disease, acute liver failure, liver cancer and rare genetic disorders.

PubMed Health Glossary
(Source: NIH - National Institute of Diabetes and Digestive and Kidney Diseases and National Library of Medicine)

About Liver Transplantation

Liver transplantation is surgery to remove a diseased or injured liver and replace it with a healthy whole liver or a segment of a liver from another person, called a donor. A successful liver transplant is a life-saving treatment for people with liver failure, a condition in which the liver no longer works as it should.

Who needs a liver transplant?

People with either acute or chronic liver failure may need a liver transplant to survive.

  • Acute liver failure (ALF) happens suddenly. Drug-induced liver injury (DILI) is the leading cause of ALF in the United States. The most common cause of DILI is an overdose of acetaminophen (Tylenol).
  • Chronic liver failure, also called end-stage liver disease, progresses over months, years, or decades. Most often, chronic liver failure is the result of cirrhosis, a condition in which scar tissue replaces healthy liver tissue until the liver cannot function adequately.

In U.S. adults, the most common reason for needing a liver transplant is cirrhosis caused by chronic hepatitis C, followed by cirrhosis caused by long-term alcohol abuse... More about Liver Transplantation NIH - National Institute of Diabetes and Digestive and Kidney Diseases and National Library of Medicine

What works? Research summarized

Evidence reviews

Routine drainage for orthotopic liver transplantation

Surgeons insert a drain (a tube emerging from the tummy to the exterior) with an intention of detecting, monitoring, or prevention of any blood or body fluids collection in the abdominal cavity after the operation. This is called abdominal drain. While this is standard practice in patients undergoing liver transplantation, some recent studies have suggested that routine use of an abdominal drainage may not be useful and even can be harmful. We searched the medical literature to find an answer to the question as to whether it is beneficial or harmful to use abdominal drains routinely in patients undergoing liver transplantation.

Cyclosporin A was without significant effects on mortality, liver transplantation, or progression of primary biliary cirrhosis, and patients given cyclosporin A experienced more adverse events

Primary biliary cirrhosis (PBC) is a chronic disease of the liver that is characterised by destruction of bile ducts. Estimates of annual incidence range from 2 to 24 people per million population, and estimates of prevalence range from 19 to 240 people per million population. PBC primarily affects middle‐aged women. The forecast for the symptomatic patient after diagnosis is between 10 and 15 years. The cause of PBC is unknown, but the dynamics of the disease resemble the group 'autoimmune disease'. Therefore, one might expect a noticeable effect of administering an immune repressing drug (immunosuppressant). This review evaluates all clinical data on the immunosuppressant cyclosporin A for PBC.

Tacrolimus is superior to cyclosporin in improving patient survival, graft survival, and in preventing acute rejection after liver transplantation, but increases post‐transplant diabetes

Almost every liver transplant recipient takes either cyclosporin or tacrolimus to prevent rejection of the graft. This is a review of the clinical trials that compared patients initially prescribed one of the two anti‐rejection drugs after liver transplantation. Sixteen trials (3813 participants) were included. The review shows that tacrolimus is marginally better than cyclosporin at preventing patient death and graft loss. Tacrolimus is substantially better than cyclosporin at preventing rejection. No differences were seen between the drugs with respect to adverse events (renal failure, lymphoproliferative disorder) except for diabetes mellitus, which was more common with tacrolimus. After liver transplantation more patients stayed on tacrolimus than on cyclosporin. Tacrolimus is more beneficial than cyclosporine and should be considered the treatment of choice after liver transplantation. This review does not evaluate the benefit or harm of switching from one anti‐rejection drug to another.

See all (368)

Summaries for consumers

Routine drainage for orthotopic liver transplantation

Surgeons insert a drain (a tube emerging from the tummy to the exterior) with an intention of detecting, monitoring, or prevention of any blood or body fluids collection in the abdominal cavity after the operation. This is called abdominal drain. While this is standard practice in patients undergoing liver transplantation, some recent studies have suggested that routine use of an abdominal drainage may not be useful and even can be harmful. We searched the medical literature to find an answer to the question as to whether it is beneficial or harmful to use abdominal drains routinely in patients undergoing liver transplantation.

Cyclosporin A was without significant effects on mortality, liver transplantation, or progression of primary biliary cirrhosis, and patients given cyclosporin A experienced more adverse events

Primary biliary cirrhosis (PBC) is a chronic disease of the liver that is characterised by destruction of bile ducts. Estimates of annual incidence range from 2 to 24 people per million population, and estimates of prevalence range from 19 to 240 people per million population. PBC primarily affects middle‐aged women. The forecast for the symptomatic patient after diagnosis is between 10 and 15 years. The cause of PBC is unknown, but the dynamics of the disease resemble the group 'autoimmune disease'. Therefore, one might expect a noticeable effect of administering an immune repressing drug (immunosuppressant). This review evaluates all clinical data on the immunosuppressant cyclosporin A for PBC.

Tacrolimus is superior to cyclosporin in improving patient survival, graft survival, and in preventing acute rejection after liver transplantation, but increases post‐transplant diabetes

Almost every liver transplant recipient takes either cyclosporin or tacrolimus to prevent rejection of the graft. This is a review of the clinical trials that compared patients initially prescribed one of the two anti‐rejection drugs after liver transplantation. Sixteen trials (3813 participants) were included. The review shows that tacrolimus is marginally better than cyclosporin at preventing patient death and graft loss. Tacrolimus is substantially better than cyclosporin at preventing rejection. No differences were seen between the drugs with respect to adverse events (renal failure, lymphoproliferative disorder) except for diabetes mellitus, which was more common with tacrolimus. After liver transplantation more patients stayed on tacrolimus than on cyclosporin. Tacrolimus is more beneficial than cyclosporine and should be considered the treatment of choice after liver transplantation. This review does not evaluate the benefit or harm of switching from one anti‐rejection drug to another.

See all (60)

More about Liver Transplantation

Photo of an adult

Also called: Liver transplant, Hepatic transplantation, Transplantation of liver

See Also: Cirrhosis, Hepatitis C

Keep up with systematic reviews on Liver Transplantation:

Create RSS

PubMed Health Blog...

read all...