EFFECTS OF ORTHOTOPIC LIVER TRANSPLANTATION

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Sixty to 80 orthotopic liver transplantations in humans are planned for the year beginning with 1982, slightly more than half of the cases being in adults. For these patients a variety of improvements from that offered in the past are planned including better immunosuppression, refinements of the technical procedure of transplantation, study of the metabolic events following liver replacement, assessment of the growth and development of children, delineation of the neuropsychiatric changes following transplantation, assessment of the new pattern of infectious disease which is emerging under therapy with cyclosporin A and steroids, accurate assessment of the function of the homografted livers and further studies of inborn errors of metabolism. Animal work is planned to improve the preservation techniques of liver homografts, to evaluate new programs of immunosuppression for potential clinical use, and to examine the largely abandoned procedure of auxiliary liver transplantation for potential use in patients with acute liver failure or in patients whose portal vein has thrombosed and who cannot be treated with liver replacement.