- Contraindications
- Selection of Donor
- Immunosuppression
- Medical Complications After Transplantation
- Success Rate
Consider in the absence of contraindications for chronic, irreversible, progressive liver disease or fulminant hepatic failure when no alternative therapy is available (Table 157-4 Indications for Liver Transplantation).
Matched for ABO blood group compatibility and liver size (reduced-size grafts may be used, esp. in children). Should be negative for HIV, HBV, and HCV. Living-donor transplant has gained increased popularity with transplantation of the right hepatic lobe from a healthy adult donor to an adult. Living-donor transplant of the left lobe accounts for one-third of all liver transplants in children.
Various combinations of tacrolimus or cyclosporine and glucocorticoids, sirolimus, everolimus, mycophenolate mofetil, or OKT3 (monoclonal antithymocyte globulin).
Medical Complications After Transplantation 
Liver graft dysfunction (primary nonfunction, acute or chronic rejection, ischemia, hepatic artery thrombosis, biliary obstruction or leak, recurrence of primary disease); infections (bacterial, viral, fungal, opportunistic); renal dysfunction; neuropsychiatric disorders, cardiovascular instability, pulmonary compromise.