Liver transplantation.
OBJECTIVE
The field of liver transplantation continues to evolve. This review discusses the major themes of controversy and investigation over the past 12 months.


RESULTS
Organ allocation remains a major area of investigation and controversy in liver transplantation. The MELD system, which has been implemented since 2002, appears to adequately predict both death on the waiting list and short-term survival after OLT. However, regional variations in allocation remain despite this system. In an attempt to further increase available organs, living donor adult transplantation has gained interest. However, with continued high rates of reported complications and additional reports of donor deaths, interest has been tempered and more diligent evaluation of the ethics and techniques for this procedure have been sought. As more patients continue to survive for longer periods after OLT, medical complications from medications are now seen and require skillful management in these individuals. Recurrent viral disease after transplant remains a significant challenge as will the increasing need for retransplantation in these patients.


CONCLUSIONS
The review of the literature in liver transplantation continues to raise more issues than answer questions. It is likely that going into the future the key themes reviewed here will remain as further studies of larger patient populations will be required to more specifically identify "best practice" for care of these individuals.
Brown
Kimberly A
KA
Henry Ford Hospital, Detroit, Michigan 48202, USA. kbrown1@hfhs.org
Moonka
Dilip
D