Liver and Pancreas Transplantation

Professor Calne performed the first liver transplant in this country in 1968 at Addenbrookes Hospital, Cambridge, shortly after he was appointed to the first Chair of Surgery in the University of Cambridge. He first described some of the experimental work carried out before work on humans could begin. He paid tribute to the pig which was able to take grafts from unrelated animals of its species and showed a slide of a pig 10 years after a successful transplant. He also paid tribute to the early experimental work done in Bristol by Joe Peacock and John Terblanche. When a donor liver has been obtained 10 hours is the maximum delay before it can be successfully grafted into a patient and helicopters and police motor cycle teams are needed for its transport. No account of tissue type is taken as this would further prolong the delay. The most difficult part of the operation is often removing the diseased liver from the patient especially when there has been previous surgery. Most of the postoperative complications arise from the biliary connections. It is always necessary to cross match 30 units of blood and massive physiological changes are produced. Sometimes it is advisable to assist the circulation with a bypass taking blood from the inferior vena cava to the aorta without using heparin as this produces severe bleeding problems. Transplants are always orthotopic, ectopic transplants placing the transplant in some other part of the abdomen has not proved successful.