[Liver transplantation--present status].

Living related liver transplantation (LPLT) as well as reduced sized graft or split liver transplantation has come from the situation with donor shortage for conventional whole liver transplantation from brain dead donors (cadaveric liver transplantation; CLT). To date, about fifty thousands liver transplants have been undergone all over the world. CLT has much diversity of the original diseases, but mainly liver cirrhosis in adults and biliary atresia in children. Original diseases for LRLT have been deviated to cholestatic diseases in childhood, but now LRLT for adults and other diseases in children, i.e. fulminant hepatitis and metabolic disorders, are increasing. The survival rate of LRLT in Kyoto University for first 230 consecutive cases was 79.5%. The main cause of death was infection-related events. There are several problems in LRLT to be resolved; perioperative management of infectious complications, how to deal with the unavoidable ABO incompatible matching transplants, how to expand the national capacity of LRLT to respond the urgent transplantations. Earlier establishment of CLT program in Japan will be necessary to make the liver transplantation the beneficial procedure for more people with end stage liver diseases.