Fortunately, liver failure is far less common than end stage renal disease. Liver transplantation was developed in the United States by Dr Thomas Starzl and pioneered in Britain in 1968. The operation which lasts about five or six hours, is one of the most complex and challenging in the entire surgical repertoire. Liver patients are nursed in intensive care for two to three days post operatively and may remain in hospital for many weeks. The one-year survival rate stands at about 75 per cent.
Children tolerate liver transplant well.
However, with 100 children entering terminal liver failure in Britain each year, some centres are trying to overcome the shortage of donor organs by fashioning appropriately sized grafts from adult livers. Until 1993, this was always done with cadaver livers in the UK, but now surgeons are attempting the same strategy with segments of liver acquired from living donors. Since the liver has massive powers of regrowth, the donor's liver regenerates within weeks. The stem cells found in bone marrow continually give rise to immature daughter cells, which differentiate into several types of blood cells. The failure of this blood forming process, as in leukaemia and certain other diseases, is lethal without treatment.