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The Sleeping Giant Awakens—Liver Transplantation in China

Liver transplantation (LTX) in the Peoples Republic of China (PRC) started in 1977 and up to 1983, 57 LTX were performed with the longest survival being 264 days—all patients had advanced hepatocellular carcinoma and recurrence was common. During a moratorium lasting the next 10 years, teams from PRC spent time abroad learning LTX. From 1993 to 1998, programs opened throughout the country and 250 LTX were performed with a 50% 1-year patient survival. Between 1999 and 2005, unbridled growth with little regulation characterized transplantation in PRC with a peak of almost 4000 LTX being performed in 2005 alone. Although there were wide variations in outcomes, several well-established centers performing more than 100 LTX annually were able to achieve 1-year and 5-year patient survival rates of 85% and 70%, respectively.