Liver Transplantation – Current Status in the Word and in the Czech Republic

Overview

Since 1983 liver transplantation (LT) has been accepted as clinical method of treatment, namely of patients with„end stage liver disease“, it is patients with the incurable phase of liver disease which excludes spontaneous recoveryor successful conservation therapy, but which is not the terminal state. Patients, indicated for LT should be thereforein generally good condition, but with a prospect of survival with conservative treatment lower than one year. Themost frequent indication in adults is the hepatic failure resulting from viral hepatitis and cholestatic diseases. Inchildren younger than 2 years it is atresia of biliary ducts, in older children metabolic diseases and fulminant failurepredominate. Children with secondary liver impairment resulting from a cystoid fibrosis or a hepatic malignancyare recommended for LT only rarely. About 8000 liver transplantations are performed annually in the world, aboutone sixth is in child recipients. Contrary to LT in adults, such operation in children has several risk moments. Theliver splitting or grafting of a hepatic segment from a living relative donor belongs to the most complicated surgicaltechniques. At the end of nineties, in the advanced centers, one-year survival reached 85 to 90% with high probabilityof improving quality of life. In the Czech Republic 60 to 70 liver transplantations are performed annually in twocenters (Prague, Brno) with comparable results.

Key words:
liver transplantation, indication, complications, present state.