Hepatic transplantation at the University of Pittsburgh: new horizons and paradigms after 30 years of experience.

In the 1993 edition of this book, we described 4 major initiatives in liver transplantation: First, the evaluation of the new immunosuppressive drug FK506 (tacrolimus); second, the feasibility of combined liver-intestinal and multivisceral transplantation; third, 2 clinical attempts at hepatic xenotransplantation; and fourth, beginning attempts to enhance donor-specific nonreactivity with adjuvant bone marrow infusion. These and other new clinical studies during the last 12 months are the concerns of this update. The topics will be considered separately because of the unique design of each and the heterogeneity of the enrolled patient population. The patient and graft survival curves were estimated by the Kaplan-Meier method and the comparisons were done by the log-rank test. Survival time for patients was defined as the time that elapsed from the transplantation date until death, or the date of the last follow-up evaluation. For calculating graft survival, the date of graft removal was also considered. Cox’s proportional hazards model was used to analyze different causes of mortality and graft failure. Single variable comparison for qualitative data was made by chi-square analysis. The one-way analysis of variance was used for 3-way comparison.