Liver Transplantation 1963 – An Organ That Regenerates Itself

In ancient Greek mythology, Prometheus suffered the wrath of Zeus and was chained to a rock, where an eagle (or, in some versions, a vulture) ate his liver every day. The liver grew back each night, making the punishment an everlasting torture. The ancient Babylonians, meanwhile, tried to predict the future by examining the features of animal livers. This practice, known as hepatoscopy, was considered a common form of divination in ancient times.

Today, we know that the liver has an extraordinary power of regeneration and can return to its normal size even after more than half of it has been removed.

People may need new livers when their own are damaged. For example, in adults, chronic hepatitis (inflammation) and cirrhosis (scarring) triggered by viruses or toxins (such as alcohol) are common causes of damage. In children, biliary atresia (an obstruction in the common bile duct that causes liver damage), a common cause of liver damage, is the most common reason for transplantation. During a liver transplant, the recipient's liver is usually removed and replaced with a liver taken from the body of a brain-dead donor. However, transplants can also be performed using part of a liver from a living donor.

American  surgeon Thomas Starzl performed the first human liver transplant in 1963. In the 1980s, the use of immunosuppressant (immune-suppressing) drugs such as ciclosporin to reduce rejection of foreign tissue made transplants more successful and widespread. Various vessels must be reconnected during transplantation, including the inferior ventricular vena cava, which receives blood from the liver through the hepatic veins; the portal vein, which drains nutrient-rich blood from the gastrointestinal tract and spleen into the liver; the hepatic artery, which supplies the liver with oxygenated blood; and the common bile duct.

The liver performs many functions, including:

• Removing toxins from the bloodstream
• Protein synthesis and breakdown
• Producing bile used in digestion
• Producing hormones involved in growth and blood pressure regulation
• Drug metabolism
• Maintaining blood sugar levels (storing glucose as glycogen in the liver and converting glycogen to glucose when needed) 

The liver also stores various vitamins, converts ammonia into urea (which is excreted in urine) and produces fibrinogen, which is needed for blood clotting.

Historical figures mentioned in the article: Thomas E. Starzl (b. 1926)

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