title: Liver transplantation: history, outcomes and perspectives.
abstract: In 1958 Francis Moore described the orthotopic liver transplantation technique in dogs. In 1963, Starzl et al. performed the first liver transplantation. In the first five liver transplantations no patient survived more than 23 days. In 1967, stimulated by Calne who used antilymphocytic serum, Starzl began a successful series of liver transplantation. Until 1977, 200 liver transplantations were performed in the world. In that period, technical problems were overcome. Roy Calne, in 1979, used the first time cyclosporine in two patients who had undergone liver transplantation. In 1989, Starzl et al. reported a series of 1,179 consecutives patients who underwent liver transplantation and reported a survival rate between one and five years of 73% and 64%, respectively. Finally, in 1990, Starzl et al. reported successful use of tacrolimus in patents undergoing liver transplantation and who had rejection despite receiving conventional immunosuppressive treatment. Liver Transplantation Program was initiated at Hospital Israelita Albert Einstein in 1990 and so far over 1,400 transplants have been done. In 2013, 102 deceased donors liver transplantations were performed. The main indications for transplantation were hepatocellular carcinoma (38%), hepatitis C virus (33.3%) and alcohol liver cirrhosis (19.6%). Of these, 36% of patients who underwent transplantation showed biological MELD score > 30. Patient and graft survival in the first year was, 82.4% and 74.8%, respectively. A major challenge in liver transplantation field is the insufficient number of donors compared with the growing demand of transplant candidates. Thus, we emphasize that appropriated donor/receptor selection, allocation and organ preservation topics should contribute to improve the number and outcomes in liver transplantation.
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Roberto Ferreira
authors.initials: RF
authors.lastname: Meirelles Júnior
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Paolo
authors.initials: P
authors.lastname: Salvalaggio
authors.affiliation: Hospital Santa Marcelina, São Paulo, SP, Brazil.
authors.forename: Marcelo Bruno de
authors.initials: MB
authors.lastname: Rezende
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Andréia Silva
authors.initials: AS
authors.lastname: Evangelista
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Bianca Della
authors.initials: BD
authors.lastname: Guardia
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Celso Eduardo Lourenço
authors.initials: CE
authors.lastname: Matielo
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Douglas Bastos
authors.initials: DB
authors.lastname: Neves
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Fernando Luis
authors.initials: FL
authors.lastname: Pandullo
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Guilherme Eduardo Gonçalves
authors.initials: GE
authors.lastname: Felga
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Jefferson André da Silva
authors.initials: JA
authors.lastname: Alves
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Lilian Amorim
authors.initials: LA
authors.lastname: Curvelo
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Luiz Gustavo Guedes
authors.initials: LG
authors.lastname: Diaz
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Marcela Balbo
authors.initials: MB
authors.lastname: Rusi
authors.affiliation: Hospital Santa Marcelina, São Paulo, SP, Brazil.
authors.forename: Marcelo de Melo
authors.initials: Mde M
authors.lastname: Viveiros
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Marcio Dias de
authors.initials: MD
authors.lastname: Almeida
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Pamella Tung
authors.initials: PT
authors.lastname: Pedroso
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Rodrigo Andrey
authors.initials: RA
authors.lastname: Rocco
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Sérgio Paiva
authors.initials: SP
authors.lastname: Meira Filho
mesh_terms: D000818:Animals; D001938:Brazil; D004285:Dogs; D006084:Graft Rejection; D006085:Graft Survival; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000266:history / Q000706:statistics & numerical data / Q000639:trends; D016896:Treatment Outcome