Survival following hepatic transplantation in the cyclosporine era.

In a series of 50 consecutive patients receiving 55 hepatic transplants, the 6-month survival was 76 per cent. Mortality was considerably higher in patients with complications of advanced liver failure (56%) than in patients that were not hospital-confined preceding the transplant procedure (10%). The causes of death were related primarily to technical errors, and uncommonly caused by rejection or uncontrollable infection. This striking change in the cause of death occurring in the cyclosporine era results from the use of more specific immunosuppression and close scrutiny of the allograft with frequent hepatic biopsy. Both of these principles diminish the reliance on high-dose corticosteroid therapy, and therefore promote wound healing and resistance to fatal infection.

Duke Scholars

Author John Wiley Williams Jr. Medicine, General Internal Medicine