ABSTRACT
In 1967, Dr. Thomas E. Starzl et al. performed the first successful deceased donor liver transplantation (DDLT) (1). For the next 15 years, poor outcomes, related to inadequate immunosuppression and technical issues, limited the application of the procedure to a very small number of centers. As results began to improve in the early 1980s, there was an exponential rise and then a plateau in the number of liver transplantations being performed. The rise was related to significant advances in immunosuppression, organ preservation, surgical techniques, and intensive care; the plateau was a natural consequence of the limited availability of appropriate donors. For most of the history of transplantation, the demand for organs has far exceeded the supply, and this has stimulated the search for innovative strategies to expand the donor pool.
