[Development of immunosuppressant treatment after liver transplant].

The history of liver transplants extends over more than 60 years. During the first 10 years the operations were carried out only as experiments and primarily focused on designing complex surgical techniques. In the 1960s the research focused on the development of immunosuppressants and the first clinical operations were performed. However, the outcomes of these interventions were very poor. The subsequent 2 decades witnessed the development of new and very efficient immunosuppressants, significantly improving patient survival rates. The number of operations and sites performing these interventions increased. In the United States in 1983, liver transplants were recognised as a clinical treatment method for liver conditions where all conservative options had failed. In the same year the first successful liver transplant was performed in Czechoslovakia. New surgical techniques bringing significant reduction of blood loss during the operation, reduction of over  extensive grafts, splitting operations -  when one organ may be used for 2 recipients -  and collection of liver lobes from living donors resulted in a further increase in the number of transplants. The development of new immunosuppressive protocols have contributed to further improved survival rates of the patients while the majority of transplant sites achieve the longterm survival of 90%. However, the future of transplants lies in inducing the immunological tolerance of the body towards the transplanted organ with no immunosuppressive treatment administered.