Evolution of liver transplant systems

This paper presents a background of the complicated biological and social contexts from early experimentation to consensus development, then focuses more in depth on advancements in systems of liver transplant. We address 1) allocation - the evolution of the transplant recipient and development of allocation systems and 2) the donor-recipient imbalance - how these large-scale systems have attempted to meet demand. From the first transplant by Starzl, to self-imposed moratoriums, the beginnings of human liver transplant were controversial. Despite significant uncertainty, improving recipient outcomes prompted the acceptance of liver transplant as non-experimental. With increasing indications and a growing recipient pool, development of an appropriate allocation system became a priority. On the pursuit of objectivity, moral systems of utility, urgency and benefit intermingle. Recently, progress has surrounded expansion of the donor pool with organ preservation devices, use of extended grafts, and emphasis on living donor transplant. The following paper will highlight the sociological intricacies and collaborative thread throughout transplant history. While controversy persists, it is crucial in bringing forward the perspectives needed to drive innovation.