Br Med J 1977 Feb 19;1(6059):471-6

Orthotopic liver transplantation: the first 60 patients.

Calne RY, Williams R

Abstract

Between May 1968 and 31 December 1976 60 orthotopic liver allografts were
transplanted by the Cambridge-King's College Hospital team. During this period
there were changes in the selection of patients and their management. Initially
some patients were operated on when they were too ill, often because of a
prolonged wait for a donor. There was a high incidence of fatal complications of
biliary drainage in patients who survived longer than the first week after
operation. Improved results have been due to the development of a simple method
of preserving the liver, thereby increasing the pool of potential donors, and by
a new technique of biliary drainage, which allows well-vascularised anastomoses
without tension, retains the sphincter of Oddi, and leaves access for
radiological examination of the biliary tree. Uncontrollable rejection of the
liver has occurred in less than 10% of cases. This contrasts strongly with the
incidence of rejection among kidney transplants. Six patients have lived for
over a year, the longest surviving for more than five years, and 13 patients
were still alive at the beginning of 1977.