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SUMMER 2006
Liver Transplantation
The UCSF Liver Transplant Service, directed by John Roberts, M.D.,
is noted for excellent success rates for both cadaveric and living donor transplants. Surgery Department
Chair Nancy Ascher, M.D., Ph.D., and Roberts
started the program in 1988. Since then, 1,830 liver transplants have been performed at UCSF.
Outcomes for cadaveric donor liver transplants at UCSF are superior, with a 92 percent one-year patient survival rate,
compared to an 87 percent average nationwide. Results for living donor liver transplants are among the best in the United States,
according to Roberts. The excellent outcomes are due in large part to the close working relationship between the surgical, hepatology
and nursing teams that care for patients, supported by specialists in anesthesiology, infectious diseases and many other disciplines.
Liver transplantation is performed in selected patients with congenital or acquired end-stage cirrhosis, hepatic-based metabolic
disorders, Budd-Chiari syndrome, primary hepatic malignancy and fulminant liver failure. Patients range in age from infants to
the elderly.
Living Donor Transplants
In comparison to other institutions, UCSF performs an unusually high number of living donor liver transplants. The technique takes advantage of the liver's ability to regenerate itself in both donor and recipient. A compatible donor, typically a family member, donates a segment of liver, which then grows in the recipient to an appropriate size within a few months. The donor's remaining liver remodels itself at a somewhat slower rate.
The living donor program at UCSF began in 1992 with adult-to-pediatric liver transplants. Sixty-six have been performed to date. Based on the success of the pediatric program, adult-to-adult transplants began in 2000, with 91 performed to date.
Because the supply of deceased donor organs is limited, recipients of cadaver livers are typically very ill before they receive a transplant. In contrast, the living donor option allows patients to undergo a transplant before their liver failure has progressed to an extreme stage.
The UCSF program specializes in innovative approaches to evaluation of the donor, who must be a healthy adult ranging in age from 18 to 55 years. Physicians routinely use preoperative CT examination of the bile duct with contrast dye to highlight the biliary tree and determine where the donor liver should be divided during surgery.
Consultations and Referrals
For more information, please call the UCSF Liver Transplant Service at (415) 353-1888.
Summer 2006 Table of Contents
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