TRANSPLANTATION

Liver transplantation is the main therapeutic choice for advanced liver pathologies, as these are diseases that can impact patient’s survival.

Thus transplantation is considered a “life-saving” therapy which, however, requires clear and specific instructions.  Organs available for transplantation are few and must be used only when a transplant is the only therapeutic option and only when it offers the patient good survival odds and a good long-term quality of life.

In case of transplantation from deceased donors, the liver is collected from brain-dead individuals (irreversible cessation of all brain function) before cardiac arrest.

The possibility of dividing the liver from a deceased donor into two functionally autonomous and transplantable parts (Split Liver) opened new horizons in liver transplantation, making it possible to transplant the organ from a single donor into two recipients.

This technique makes it possible to transplant the left liver lobe into a paediatric recipient and the right lobe into an adult recipient.  This procedure was perfected in order to remedy the paucity of available organs for paediatric patients, while at the same time satisfying the transplantation needs of adult patients.

The implementation of the split liver from deceased donor procedure, which is very well developed in Italy, has allowed Italy to fully cover the requests for paediatric patients in full.

An additional, more recent opportunity, exploited in a small number of cases and also aimed at remedying the paucity of available organs, consists of collecting some hepatic tissue from a living donor, who is often a relative of the patient’s. A living-donor liver transplant is based on the fact that both the transplanted liver portion and the donor’s remaining liver can regenerate themselves, restoring the hepatic mass almost entirely in about 4 weeks from the operation.

Regardless of the specific technique utilised, liver transplants nowadays have a success rate of over 80% of cases one year after the surgery and 65% after five years, with differences due to the underlying pathology and the patient’s clinical conditions at the time of transplantation.

Survival results in Italy care comparable and sometimes even exceed those recorded in the European Liver Transplant Registry.