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{{CMG}}; {{AE}} {{Soroush}}
{{CMG}}; {{AE}} {{Soroush}}
==Overview==
==Overview==
*My refernces
 
<ref name="pmid18509123">Rodríguez-Roisin R, Krowka MJ (2008) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=18509123 Hepatopulmonary syndrome--a liver-induced lung vascular disorder.] ''N Engl J Med'' 358 (22):2378-87. [http://dx.doi.org/10.1056/NEJMra0707185 DOI:10.1056/NEJMra0707185] PMID: [https://pubmed.gov/18509123 18509123]</ref>
* In 1884, Flückiger was the first to report the association between liver dysfunction and the development of hypoxemia. (Flückiger M. Vorkommen von trommelschlagel-formigen fingerendphalangen ohne chronische veranderungeng an den lungen oder am herzen. Wien Med Wochenschr. 1884;34:1457.) The term "hepatopulmonary syndrome" was first suggested by Kennedy and Knudson almost 100 years later,in 1977 during describing a patient with the classic findings of hepatopulmonary syndrome.
<ref name="pmid11003635">Fallon MB, Abrams GA (2000) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11003635 Pulmonary dysfunction in chronic liver disease.] ''Hepatology'' 32 (4 Pt 1):859-65. [http://dx.doi.org/10.1053/jhep.2000.7519 DOI:10.1053/jhep.2000.7519] PMID: [https://pubmed.gov/11003635 11003635]</ref>
<ref name="pmid14762853">Krowka MJ, Mandell MS, Ramsay MA, Kawut SM, Fallon MB, Manzarbeitia C et al. (2004) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=14762853 Hepatopulmonary syndrome and portopulmonary hypertension: a report of the multicenter liver transplant database.] ''Liver Transpl'' 10 (2):174-82. [http://dx.doi.org/10.1002/lt.20016 DOI:10.1002/lt.20016] PMID: [https://pubmed.gov/14762853 14762853]</ref>
4. Flückiger M. Vorkommen von trommelschlagel-formigen fingerendphalangen ohne chronische veranderungeng an den lungen oder am herzen. Wien Med Wochenschr. 1884;34:1457.
<ref name="pmid891282">Kennedy TC, Knudson RJ (1977) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=891282 Exercise-aggravated hypoxemia and orthodeoxia in cirrhosis.] ''Chest'' 72 (3):305-9. [http://dx.doi.org/10.1378/chest.72.3.305 DOI:10.1378/chest.72.3.305] PMID: [https://pubmed.gov/891282 891282]</ref>
<ref name="pmid27326810">Krowka MJ, Fallon MB, Kawut SM, Fuhrmann V, Heimbach JK, Ramsay MA et al. (2016) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=27326810 International Liver Transplant Society Practice Guidelines: Diagnosis and Management of Hepatopulmonary Syndrome and Portopulmonary Hypertension.] ''Transplantation'' 100 (7):1440-52. [http://dx.doi.org/10.1097/TP.0000000000001229 DOI:10.1097/TP.0000000000001229] PMID: [https://pubmed.gov/27326810 27326810]</ref>
<ref name="pmid8101797">Krowka MJ, Dickson ER, Cortese DA (1993) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8101797 Hepatopulmonary syndrome. Clinical observations and lack of therapeutic response to somatostatin analogue.] ''Chest'' 104 (2):515-21. [http://dx.doi.org/10.1378/chest.104.2.515 DOI:10.1378/chest.104.2.515] PMID: [https://pubmed.gov/8101797 8101797]</ref>
<ref name="pmid15828054">Swanson KL, Wiesner RH, Krowka MJ (2005) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=15828054 Natural history of hepatopulmonary syndrome: Impact of liver transplantation.] ''Hepatology'' 41 (5):1122-9. [http://dx.doi.org/10.1002/hep.20658 DOI:10.1002/hep.20658] PMID: [https://pubmed.gov/15828054 15828054]</ref>
<ref name="pmid1465744">Rodríguez-Roisin R, Agustí AG, Roca J (1992) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=1465744 The hepatopulmonary syndrome: new name, old complexities.] ''Thorax'' 47 (11):897-902. [http://dx.doi.org/10.1136/thx.47.11.897 DOI:10.1136/thx.47.11.897] PMID: [https://pubmed.gov/1465744 1465744]</ref>
<ref name="pmid8620957">Cremona G, Higenbottam TW, Mayoral V, Alexander G, Demoncheaux E, Borland C et al. (1995) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8620957 Elevated exhaled nitric oxide in patients with hepatopulmonary syndrome.] ''Eur Respir J'' 8 (11):1883-5. PMID: [https://pubmed.gov/8620957 8620957]</ref>
<ref name="pmid9328302">Rolla G, Brussino L, Colagrande P, Dutto L, Polizzi S, Scappaticci E et al. (1997) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9328302 Exhaled nitric oxide and oxygenation abnormalities in hepatic cirrhosis.] ''Hepatology'' 26 (4):842-7. [http://dx.doi.org/10.1053/jhep.1997.v26.pm0009328302 DOI:10.1053/jhep.1997.v26.pm0009328302] PMID: [https://pubmed.gov/9328302 9328302]</ref>
<ref name="pmid11549549">Nunes H, Lebrec D, Mazmanian M, Capron F, Heller J, Tazi KA et al. (2001) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11549549 Role of nitric oxide in hepatopulmonary syndrome in cirrhotic rats.] ''Am J Respir Crit Care Med'' 164 (5):879-85. [http://dx.doi.org/10.1164/ajrccm.164.5.2009008 DOI:10.1164/ajrccm.164.5.2009008] PMID: [https://pubmed.gov/11549549 11549549]</ref>
<ref name="pmid9824266">Luo B, Abrams GA, Fallon MB (1998) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9824266 Endothelin-1 in the rat bile duct ligation model of hepatopulmonary syndrome: correlation with pulmonary dysfunction.] ''J Hepatol'' 29 (4):571-8. PMID: [https://pubmed.gov/9824266 9824266]</ref>
<ref name="pmid24731444">Zhang J, Yang W, Hu B, Wu W, Fallon MB (2014) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24731444 Endothelin-1 activation of the endothelin B receptor modulates pulmonary endothelial CX3CL1 and contributes to pulmonary angiogenesis in experimental hepatopulmonary syndrome.] ''Am J Pathol'' 184 (6):1706-14. [http://dx.doi.org/10.1016/j.ajpath.2014.02.027 DOI:10.1016/j.ajpath.2014.02.027] PMID: [https://pubmed.gov/24731444 24731444]</ref>
<ref name="pmid16628648">Gómez FP, Barberà JA, Roca J, Burgos F, Gistau C, Rodríguez-Roisin R (2006) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16628648 Effects of nebulized N(G)-nitro-L-arginine methyl ester in patients with hepatopulmonary syndrome.] ''Hepatology'' 43 (5):1084-91. [http://dx.doi.org/10.1002/hep.21141 DOI:10.1002/hep.21141] PMID: [https://pubmed.gov/16628648 16628648]</ref>
<ref name="pmid12427789">Schenk P, Fuhrmann V, Madl C, Funk G, Lehr S, Kandel O et al. (2002) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=12427789 Hepatopulmonary syndrome: prevalence and predictive value of various cut offs for arterial oxygenation and their clinical consequences.] ''Gut'' 51 (6):853-9. [http://dx.doi.org/10.1136/gut.51.6.853 DOI:10.1136/gut.51.6.853] PMID: [https://pubmed.gov/12427789 12427789]</ref>
<ref name="pmid7557096">Abrams GA, Jaffe CC, Hoffer PB, Binder HJ, Fallon MB (1995) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7557096 Diagnostic utility of contrast echocardiography and lung perfusion scan in patients with hepatopulmonary syndrome.] ''Gastroenterology'' 109 (4):1283-8. PMID: [https://pubmed.gov/7557096 7557096]</ref>
<ref name="pmid14708947">Lima BL, França AV, Pazin-Filho A, Araújo WM, Martinez JA, Maciel BC et al. (2004) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=14708947 Frequency, clinical characteristics, and respiratory parameters of hepatopulmonary syndrome.] ''Mayo Clin Proc'' 79 (1):42-8. [http://dx.doi.org/10.4065/79.1.42 DOI:10.4065/79.1.42] PMID: [https://pubmed.gov/14708947 14708947]</ref>
<ref name="pmid11434610">Martínez GP, Barberà JA, Visa J, Rimola A, Paré JC, Roca J et al. (2001) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11434610 Hepatopulmonary syndrome in candidates for liver transplantation.] ''J Hepatol'' 34 (5):651-7. PMID: [https://pubmed.gov/11434610 11434610]</ref>
<ref name="pmid14517788">Schenk P, Schöniger-Hekele M, Fuhrmann V, Madl C, Silberhumer G, Müller C (2003) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=14517788 Prognostic significance of the hepatopulmonary syndrome in patients with cirrhosis.] ''Gastroenterology'' 125 (4):1042-52. PMID: [https://pubmed.gov/14517788 14517788]</ref>
<ref name="pmid1642191">Hopkins WE, Waggoner AD, Barzilai B (1992) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=1642191 Frequency and significance of intrapulmonary right-to-left shunting in end-stage hepatic disease.] ''Am J Cardiol'' 70 (4):516-9. [http://dx.doi.org/10.1016/0002-9149(92)91200-n DOI:10.1016/0002-9149(92)91200-n] PMID: [https://pubmed.gov/1642191 1642191]</ref>
<ref name="pmid17392034">Arguedas MR, Singh H, Faulk DK, Fallon MB (2007) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17392034 Utility of pulse oximetry screening for hepatopulmonary syndrome.] ''Clin Gastroenterol Hepatol'' 5 (6):749-54. [http://dx.doi.org/10.1016/j.cgh.2006.12.003 DOI:10.1016/j.cgh.2006.12.003] PMID: [https://pubmed.gov/17392034 17392034]</ref>
<ref name="pmid15516683">Rodríguez-Roisin R, Krowka MJ, Hervé P, Fallon MB, ERS Task Force Pulmonary-Hepatic Vascular Disorders (PHD) Scientific Committee (2004) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=15516683 Pulmonary-Hepatic vascular Disorders (PHD).] ''Eur Respir J'' 24 (5):861-80. [http://dx.doi.org/10.1183/09031936.04.00010904 DOI:10.1183/09031936.04.00010904] PMID: [https://pubmed.gov/15516683 15516683]</ref>
<ref name="pmid8665789">Castro M, Krowka MJ (1996) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8665789 Hepatopulmonary syndrome. A pulmonary vascular complication of liver disease.] ''Clin Chest Med'' 17 (1):35-48. PMID: [https://pubmed.gov/8665789 8665789]</ref>
<ref name="pmid25954542">Hurtado-Cordovi JM, Lipka S, Singh J, Shahzad G, Mustacchia P (2011) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=25954542 Diagnostic challenge of hepatopulmonary syndrome in a patient with coexisting structural heart disease.] ''Case Reports Hepatol'' 2011 ():386709. [http://dx.doi.org/10.1155/2011/386709 DOI:10.1155/2011/386709] PMID: [https://pubmed.gov/25954542 25954542]</ref>
<ref name="pmid9453490">Abrams GA, Nanda NC, Dubovsky EV, Krowka MJ, Fallon MB (1998) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9453490 Use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: a new approach.] ''Gastroenterology'' 114 (2):305-10. PMID: [https://pubmed.gov/9453490 9453490]</ref>
<ref name="pmid27384058">Chen YA, Prabhudesai V, Castel H, Gupta S (2016) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=27384058 CT Scan Does Not Differentiate Patients with Hepatopulmonary Syndrome from Other Patients with Liver Disease.] ''PLoS One'' 11 (7):e0158637. [http://dx.doi.org/10.1371/journal.pone.0158637 DOI:10.1371/journal.pone.0158637] PMID: [https://pubmed.gov/27384058 27384058]</ref>
<ref name="pmid24142412">Nayyar D, Man HS, Granton J, Gupta S (2014) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24142412 Defining and characterizing severe hypoxemia after liver transplantation in hepatopulmonary syndrome.] ''Liver Transpl'' 20 (2):182-90. [http://dx.doi.org/10.1002/lt.23776 DOI:10.1002/lt.23776] PMID: [https://pubmed.gov/24142412 24142412]</ref>
<ref name="pmid25649047">Nayyar D, Man HS, Granton J, Lilly LB, Gupta S (2015) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=25649047 Proposed management algorithm for severe hypoxemia after liver transplantation in the hepatopulmonary syndrome.] ''Am J Transplant'' 15 (4):903-13. [http://dx.doi.org/10.1111/ajt.13177 DOI:10.1111/ajt.13177] PMID: [https://pubmed.gov/25649047 25649047]</ref>
<ref name="pmid24757662">Park TJ, Ahn KS, Kim YH, Kim H, Park UJ, Kim HT et al. (2014) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24757662 Improved severe hepatopulmonary syndrome after liver transplantation in an adolescent with end-stage liver disease secondary to biliary atresia.] ''Clin Mol Hepatol'' 20 (1):76-80. [http://dx.doi.org/10.3350/cmh.2014.20.1.76 DOI:10.3350/cmh.2014.20.1.76] PMID: [https://pubmed.gov/24757662 24757662]</ref>


==Historical Perspective==
==Historical Perspective==


===Discovery===
===Discovery===
* There is limited information about the historical perspective of [disease name].
OR
*[Disease name] was first discovered by [name of scientist], a [nationality + occupation], in [year]/during/following [event].


*The association between [important risk factor/cause] and [disease name] was made in/during [year/event].
*In 1884, Flückiger was the first to report the association between liver dysfunction and the development of hypoxemia. (Flückiger M. Vorkommen von trommelschlagel-formigen fingerendphalangen ohne chronische veranderungeng an den lungen oder am herzen. Wien Med Wochenschr. 1884;34:1457.)
*In [year], [scientist] was the first to discover the association between [risk factor] and the development of [disease name].
*The term "hepatopulmonary syndrome" was first suggested by Kennedy and Knudson almost 100 years later,in 1977 during describing a patient with the classic findings of hepatopulmonary syndrome.<ref name="pmid891282">Kennedy TC, Knudson RJ (1977) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=891282 Exercise-aggravated hypoxemia and orthodeoxia in cirrhosis.] ''Chest'' 72 (3):305-9. [http://dx.doi.org/10.1378/chest.72.3.305 DOI:10.1378/chest.72.3.305] PMID: [https://pubmed.gov/891282 891282]</ref>
*In [year], [gene] mutations were first implicated in the pathogenesis of [disease name].


===Landmark Events in the Development of Treatment Strategies===
===Landmark Events in the Development of Treatment Strategies===


===Impact on Cultural History===
* Currently the only definitive treatment is liver transplantation. Alternative treatments such as supplemental oxygen or somatostatin to inhibit vasodilation remains anecdotal.
 
* Here are the landmarks of liver transplantation pathway.
===Famous Cases===
:* In the 1960s, Thomas Starzl used dogs as the first animals for [[research]] on liver transplantation in Boston and Chicago.
The following are a few famous cases of [disease name]:
:* In 1963, the first liver transplant in humans was attempted by a surgical team led by Dr. Thomas Starzl of Denver, Colorado, United States.
:* Dr. Starzl performed many additional [[Organ transplant|transplants]] until he was successful in 1967 with the first one-year survival post-transplantation.
:* In 1970, the regimen for [[Immunosuppression|immunosuppressive therapy]] following [[Organ transplant|transplant]] was introduced, but [[azathioprine]] and [[Steroid|steroids]] did not improve survival rates of patients.
:* In the 1980s, with the introduction of [[cyclosporine]] by Sir Roy Calne, there was an improvement in [[Transplant rejection|rejection]] rates.
:* In 1983, liver transplantation was no longer an experimental modality, but a clinically accepted form of therapy for both adult and pediatric patients with appropriate indications.
:* In 1986, the introduction of [[monoclonal antibodies]] such as [[muromonab-CD3]] [OKT3] further contributed to improvement of quality of [[Immunosuppression|immunosuppressive therapy]] used in [[Patient|patients]], with significant decline in [[Transplant rejection|rejection rates]].
:* In 1988, University of Wisconsin (UW) solution was developed, which ensured a smooth [[surgery]] and longer preservation period.
:* In 1992, the concept of [[xenotransplantation]] and [[cloning]] techniques were introduced by Starzl.
:* In 1999, approximately 5000 procedures were carried out, in contrast to 100 which had been performed a decade earlier.
:* Recently, the introduction of newer [[immunosuppressive agents]] such as [[IL-2 receptor]] blockers and [[tacrolimus]], have drastically increased patient [[Survival rate|survival rates]]<nowiki/>to 1 and 5-year rates of approximately 85 and 70 percent respectively.
:* In December 2016, 147,128 liver transplants were performed in the US as compared to 7217 in 1998 based on data from the United Organ Sharing (UNOS) network.


<br />
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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[[Category: Pulmonary Medicine]]
[[Category: Pulmonary Medicine]]
[[Category: Pulmonology]]
[[Category: Pulmonology]]
[[Category:Surgery]]
[[Category:Medicine]]
[[Category:Pulmonology]]
[[Category:Cardiology]]
[[Category:Gastroentrology]]
[[Category:Up-To-Date]]

Latest revision as of 17:53, 6 September 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]

Overview

  • In 1884, Flückiger was the first to report the association between liver dysfunction and the development of hypoxemia. (Flückiger M. Vorkommen von trommelschlagel-formigen fingerendphalangen ohne chronische veranderungeng an den lungen oder am herzen. Wien Med Wochenschr. 1884;34:1457.) The term "hepatopulmonary syndrome" was first suggested by Kennedy and Knudson almost 100 years later,in 1977 during describing a patient with the classic findings of hepatopulmonary syndrome.

Historical Perspective

Discovery

  • In 1884, Flückiger was the first to report the association between liver dysfunction and the development of hypoxemia. (Flückiger M. Vorkommen von trommelschlagel-formigen fingerendphalangen ohne chronische veranderungeng an den lungen oder am herzen. Wien Med Wochenschr. 1884;34:1457.)
  • The term "hepatopulmonary syndrome" was first suggested by Kennedy and Knudson almost 100 years later,in 1977 during describing a patient with the classic findings of hepatopulmonary syndrome.[1]

Landmark Events in the Development of Treatment Strategies

  • Currently the only definitive treatment is liver transplantation. Alternative treatments such as supplemental oxygen or somatostatin to inhibit vasodilation remains anecdotal.
  • Here are the landmarks of liver transplantation pathway.
  • In the 1960s, Thomas Starzl used dogs as the first animals for research on liver transplantation in Boston and Chicago.
  • In 1963, the first liver transplant in humans was attempted by a surgical team led by Dr. Thomas Starzl of Denver, Colorado, United States.
  • Dr. Starzl performed many additional transplants until he was successful in 1967 with the first one-year survival post-transplantation.
  • In 1970, the regimen for immunosuppressive therapy following transplant was introduced, but azathioprine and steroids did not improve survival rates of patients.
  • In the 1980s, with the introduction of cyclosporine by Sir Roy Calne, there was an improvement in rejection rates.
  • In 1983, liver transplantation was no longer an experimental modality, but a clinically accepted form of therapy for both adult and pediatric patients with appropriate indications.
  • In 1986, the introduction of monoclonal antibodies such as muromonab-CD3 [OKT3] further contributed to improvement of quality of immunosuppressive therapy used in patients, with significant decline in rejection rates.
  • In 1988, University of Wisconsin (UW) solution was developed, which ensured a smooth surgery and longer preservation period.
  • In 1992, the concept of xenotransplantation and cloning techniques were introduced by Starzl.
  • In 1999, approximately 5000 procedures were carried out, in contrast to 100 which had been performed a decade earlier.
  • Recently, the introduction of newer immunosuppressive agents such as IL-2 receptor blockers and tacrolimus, have drastically increased patient survival ratesto 1 and 5-year rates of approximately 85 and 70 percent respectively.
  • In December 2016, 147,128 liver transplants were performed in the US as compared to 7217 in 1998 based on data from the United Organ Sharing (UNOS) network.


References