MELD score helps assess liver disease severity and predict transplant needs. Started as Child-Turcotte-Pugh score update in 2000. Developed by UNOS and supported by American Liver Foundation
Available in capsules, tablets, suspension, powder, and delayed-release tablets. Mycophenolate mofetil: 1g PO/IV q12hr for kidney transplant. Mycophenolic acid: 720mg PO q12hr for kidney transplant. Heart transplant: 1.5g PO/IV q12hr for allogeneic heart transplant. Liver transplant: 1g IV q12hr or 1.5g PO q12hr for allogeneic liver transplant
Milan criteria established in 1996 by Mazzaferro et al. for cirrhosis and HCC patients. Criteria include one lesion smaller than 5 cm or up to three smaller than 3 cm. No extrahepatic manifestations or gross vascular invasion allowed. Criteria adopted by OPTN for transplantation evaluation
Liver transplant replaces diseased liver with donor's liver. Most adult patients need transplant for cirrhosis or liver cancer. Pediatric patients require transplant for inherited liver diseases. Donor livers can be deceased or living (living donor)
Liver transplantation replaces diseased liver with healthy donor liver. Treatment option for end-stage liver disease and acute liver failure. Highly regulated procedure performed at designated transplant centers. Outcomes highly variable due to donor organ availability limitations
First written mention of transplantation dates to 1550 BC. John Hunter performed first animal tissue transplants in 1728. First successful human kidney transplant performed in 1933. First successful liver transplant attempted by Thomas Starzl in 1963