December 2, 1983

Liver transplants: big business in blood

JAMA. 1983;250(21):2904-2905. doi:10.1001/jama.1983.03340210008003

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More than 500 liver transplants have been performed in the past 20 years, mostly in the United States, Great Britain, West Germany, and the Netherlands (Lancet 1983;2:778-779). In the next ten years, some experts think that every major center for treatment of liver disease will have access to transplant capabilities (Hepatology 1982;2:616-636).

But will they?

For one thing, not all hospitals can deploy the large support staff that such surgery demands. Every one of the approximately 100 liver transplants that will be done this year at Pittsburgh's Presbyterian-University Hospital or Children's Hospital, for example, involves up to a dozen types of medical specialists: surgeons, anesthesiologists, nurses, and blood bank personnel, as well as a gastroenterologist, immunologist, hematologist, nephrologist, radiologist, pulmonologist, infectious disease specialist, and psychiatrist.

And there is another hefty requirement: The amount needed of what Goethe's Devil called that "very special juice" far exceeds that required for any other