From the Gastrointestinal Unit, Department of Medicine (J.L.D.), and the Transplantation Unit, Department of Surgery (A.B.C.), Massachusetts General Hospital and Harvard Medical School, Boston.
The history of medicine is that what was inconceivable yesterday and barely achievable today often becomes routine tomorrow.(1) Little more than a generation ago, treatment options for end-stage liver disease were few and of limited durable utility. Little could be done to stem the decline of affected patients, who would ultimately go on to have liver failure and portal hypertension - variceal bleeding, intractable ascites, peritonitis, jaundice, hepatic encephalopathy, and coagulopathy - culminating in multisystem failure. All that changed in 1983, when successes in experimental liver transplantation justified the procedure's generalization as standard treatment. In a tribute to the pioneers . . .