The hepatic transplantation , or clerk's office of the liver , is an surgical operation consisting in replacing a sick Foie by a healthy liver, taken on a Donneur.
The liver being the only body having the capacity to regenerate itself, it is possible to carry out a hepatic transplantation starting from a Greffon taken in an alive donor, pertaining to the family close to the Receveur. Most frequently, the graft comes from a donor declared in a state of encephalic death.
To avoid the Rejection, it is necessary to have a Compatibilité optimal HLA and the treatment Immunosuppresseur is essential. For certain fulminant hepatitises, the urgency can bring not to take account of compatibility HLA.
; the Sixties
March 1st 1963: the first hepatic transplantation carried out by Pr Thomas Starzl at a 3 year old patient reaches of a Atrésie bile Ducts having led to a hepatic Insuffisance. The deceased child of a hemorrhage at the time of the operation which takes place with Denver, Colorado.
1963: four other unfruitful interventions are carried out in adults
; the Seventies
; the Eighties
The arrival of Ciclosporine has, powerful treatment Immunosuppresseur, will allow the rise of hepatic transplantation.
Many doctors come to improve with Pittsburgh, become the center pionner.
August 1984: the first hepatic transplantation in the child with a liver reduced to Leuwen
January 1988: hepatic transplantations in the adult with graft resulting from an alive donor
; the Nineties
- chronic Cholestase: primitive biliary cirrhosis, cholangite sclerosing, atresy of the bile ducts
- Cirrhosis: of alcoholic origin (weaning must be higher than 6 months), viral (Hépatite B, Hépatite C), auto-immune…
- metabolic Hépatopathie: Hémochromatose, Disease of Wilson
- primitive Cancers of the liver: according to certain criteria resulting from consensus, like the criteria of Milan
- Others: Syndrome of Budd-Chiari
not separated alcoholic Cirrhosis
- hepatic Tumors apart from the criteria favorable to transplantation
- Heart failure or respiratory
- congenital or acquired immunizing Deficit (HIV)
- cerebral Atrophy
Complications related to the intervention and causal pathology
Malfunction of the graft, hemorrhages and thrombosis of the hepatic artery.
Repeat of causal pathology on the graft: alcoholism not separated, hepatitis B or C
Rejections and complications related to the immunosuppressor treatment
Rejection hyperaigu, acute rejection or chronic rejection.
Infections bacterial, viral and parasitic, néoplasies related to the immunosuppression
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