Liver transplant

Liver transplant technology is developed from research results in several areas of medical study. In 1953, Billingham, Brent, and Medawar found that tolerance can be induced by infusion kimerisme hematolimfopoietik donor cells in mouse models.
In the 1958 study developed a theory about the canines hepatotrofik molecules in the portal veins in the liver and found insulin as the main hepatotrofik factor of some other factors exist. At almost the same theory about multiviseral and liver transplantation also grown from immunosuppression studies the empirical study of pattern recognition algorithms and therapeutic response. In early 1960, proved that humans have canines and allograft tolerance can be induced kimersime automatically with the aid of immunosuppression, until the end of 1962 concluded with a mistake, that the transplant involves two different immune systems. Consequences of these conclusions to be dogma that the heart tolerogenisitas, basically, different, not only with bone marrow, but with all other body organs. This mistake is not corrected properly until 1990.
The first liver transplant was conducted in Denver in 1963, first success was recorded in 1967 with azatioprina, prednisone and anti-lymphoid globulin, by Thomas E. Starzl of the United States, followed by the successful transplantation of human spinal cord in 1968. Time span between 1967 to 1979 recorded 84 times a liver transplant in children with 30% survival up to two years. Study the development of immunosuppression and provide improvements and a longer life expectancy for patients, among others, by the turn of azatioprina with siklosporina in 1979, then replaced with takrolimus in 1989.
In 1992, developed the theory mikrokimerisme donor leukocytes from donors with a range of different lineage, which provide extremely long life expectancy for an organ donor recipient, having known the relationship between immunological aspects of transplantation, infection, tolerance by bone marrow, neoplasms and autoimmune disorders, called as a seminal mechanism. Immune response and immune tolerance between donor organs and the body was found is a function of leukocyte migration and localization. One of the findings are derived immune system activation by NK cells and interferon-γ immediately after the transplant is completed. In the mouse model, hepatocyte cell donor was found to be highly antigenic triggering rejection response, which can be done independently or jointly between CD4 T cells and CD8 T cells.
For that needed intensive immunosuppressive therapy before the transplant done, which is called preparative or conditioning regimen to prevent rejection of donor organs by the host immune system. Immunosuppressive therapies are intended to suppress T cell and host NK cells in order to provide space in the bone marrow for hematopoietic stem cell transplants from organ donors through mielosupresif therapy, to balance repopulasi donor cell to cell differentiation results from the host stem cells.
Today, heart transplants performed only when the heart has entered the final stage of a disease, or dysfunction has occurred with acute fulminant hepatic failure referred. Cases of liver transplantation in humans is commonly caused by cirrhosis of the liver resulting from chronic hepatitis C, alcohol dependence, etc. autoimmune hepatitis.
Common technique used is ortotopik transplants, the placement of donor organs in the same anatomic position with the starting position before the organ. Liver transplant could potentially be applied, only if the recipient of donor organs has no other burdensome conditions, such as metastatic cancer outside the liver, the dependence on drugs or alcohol. Some experts based on Milan criteria for liver transplant patient selection.
Organ donors, called allograft, usually derived from other human beings who just died from traumatic brain injury (kadaverik). Other transplantation techniques using human organs that are still alive, picked up 20% operating hepatektomi liver Coinaud second and third segments of the adult to the donor to a child, in 1989.