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Technology Assessment Applied to Liver Transplantation in Adults

Published online by Cambridge University Press:  10 March 2009

Willis R. Foster  and
Benjamin T. Burton
Willis R. Foster
Affiliation:
National Institutes of Health
Benjamin T. Burton
Affiliation:
National Institutes of Health
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Extract

This article is a review of liver transplantation in adults, in the context of ongoing technology assessments of the National Institutes of Health (NIH). Liver transplantation in adults has become an accepted therapeutic procedure for end-stage liver disease, as it is practiced in established programs of a number of experienced institutions. The number of medical centers instituting programs of liver transplantation has greatly increased since the 1983 NIH Consensus Conference on this subject, and this article traces the clear relationship between the experience level of the institution and the end result of adult transplantation. Five determinants of the survival rate, safety, and efficacy of liver transplantation are discussed: the supply of donor organs, the selection criteria for transplantation candidates, surgical technique, the support system and support staff available, and adequate suppression of the immunological response. Medical diagnoses most likely to produce successful results are enumerated.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 5 , Issue 2 , April 1989 , pp. 173 - 182
Copyright
Copyright © Cambridge University Press 1989

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References

REFERENCES

Beswick, D. R., & Boyer, J. L.Primary biliary cirrhosis. Hepatology, 1984, 4 (1 Suppl), 29S–32S.CrossRefGoogle ScholarPubMed
Burton, B. T., & Heyse, S. P.Technology assessment in biomedical research: Magnetic resonance imaging as a case in point. Journal of Nuclear Medicine and Allied Sciences, 1985, 29, 331–35.Google ScholarPubMed
Calne, R. Y., ed. Liver transplantation: The Cambridge-King's College experience. New York: Grune & Stratton, 1983, 35–66, 343–71.Google Scholar
Cuthbert, J. A.Southwestern Internal Medicine Conference: Hepatic transplantation. American Journal of the Medical Sciences, 1986, 291, 286–95.CrossRefGoogle Scholar
Lai, C. L., Ng, M. M. T., Wu, P. C., et al. Mortality and prognostic indicators in hepatitis-B associated chronic active hepatitis. Hepatology, 1983, 3, 836 (A155).Google Scholar
Marsh, J. W., et al. Liver transplantation today. Postgraduate Medicine, 1987, 81, 13–23.CrossRefGoogle ScholarPubMed
National Institutes of Health, Consensus Development Conference on Liver Transplantation – June 20–23, 1983. Hepatology, 1984, 4 (1 Suppl), 1S–110S.Google Scholar
Roll, J., et al. . The prognostic importance of clinical and histologic features in asymptomatic and symptomatic primary biliary cirrhosis. New England Journal of Medicine, 1983, 308, 1–7.CrossRefGoogle ScholarPubMed
Scharschmidt, B. F.Human liver transplantation: Analysis of data on 540 patients from four centers. Hepatology, 1984, 4 (1 Suppl.), 95S–101S.CrossRefGoogle ScholarPubMed
Scharschmidt, B. F.Human liver transplantation: An analysis of 819 patients from eight centers. Recent Advances in Hepatology, 1986, 2, 175–89.Google Scholar
Sheahan, D. G., & Dekker, A.Hepatic transplantation: The role of the pathologist. Journal of Clinical Gastroenterology, 1986, 8, 5–7.CrossRefGoogle ScholarPubMed
Sherlock, S.Hepatic transplantation. Southern Medical Journal, 1987, 80, 357–61.CrossRefGoogle ScholarPubMed
Starzl, T. E., Iwatsuki, S., & Shaw, B. W. Liver homotransplantation. In Sabiston, D. C. (ed.), Textbook of surgery: The biological basis of modern surgical practice, 13th ed. Philadelphia: W. B. Saunders, 1986, 457–68.Google Scholar
Starzl, T. E., Todo, S., Gordon, R., et al. Liver transplantation in older patients (letter), New England Journal of Medicine, 1987, 316, 484–85.Google Scholar
Tzakis, A. G., Gordon, R. D., Makowka, L., et al. Clinical considerations in orthotopic liver transplantation. Radiologic Clinics of North America, 1987, 25, 289–97.Google ScholarPubMed
Van Thiel, D. H., & Gavaler, J. S.Recurrent disease in patients with liver transplantation: When does it occur and how can we be sure? Hepatology, 1987, 7, 181–83.CrossRefGoogle ScholarPubMed
Van Thiel, D. H., Schade, R. R., Gavaler, J. S., et al. Medical aspects of liver transplantation. Hepatology, 1984, 4 (1 Suppl.), 79S–83S.CrossRefGoogle ScholarPubMed
Van Thiel, D. H., Schade, R. R., Hakala, T. R., et al. Liver procurement for orthotopic transplantation: An analysis of the Pittsburgh experience. Hepatology, 1984, 4 (1 Suppl.), 66S–71S.CrossRefGoogle ScholarPubMed
Van Thiel, D. H., Schade, R. R., Starzl, T. E., et al. Liver transplantation in adults. Hepatology, 1982, 2, 637–40.CrossRefGoogle ScholarPubMed
Vierling, J. M.Epidemiology and clinical course of liver diseases: Identification of candidates for hepatic transplantation. Hepalology, 1984, 4 (1 Suppl.), 84S–94S.CrossRefGoogle ScholarPubMed
Wiesner, R. H., Dickson, E. R., Krom, R. F., et al. Estimating survival in patients with primary biliary cirrhosis, primary sclerosing cholangitis, and autoimmune chronic active hepatitis: Application to liver transplantation. Hepatology, 1985, 5, 1020.Google Scholar