The evolution of liver transplantation to today is gratifying. With all of the accolades deservedly recognizing Dr. Starzl, the honor bestowed upon Dr. Starzl by Dr. Haberal is a genuine expression of the appreciation of liver transplant professionals around the world.

However, the past 50 years brings an important challenge to the next period of liver transplantation history. That challenge is the donor source of the liver allograft.

The disparity of living to deceased organ transplantation is striking worldwide. There are countries that are practicing liver transplantation without a deceased donor program. The burden placed upon the living donor is significant when one considers the mortality rate of the donor estimated to be 1 in 300 right lobe donors. This observation should be compelling for liver transplant surgeons to embrace deceased organ donation and propel its development. The potential of deceased organ transplantation has not been realized around the world. Ministries of Health must be engaged to support deceased organ donation by the alliance of the liver transplant community.

There is a science of deceased organ donation that is about to unfold that hopefully will be embraced by liver transplant surgeons again worldwide. It is the ex vivo repair of the deceased donor liver allograft.

Research grants should be secured to foster this approach to the expansion of recovering liver allografts from a deceased donor source. We are at the very beginning stages of that scientific effort. It will be a revealing testimony of liver transplantation when its history is examined in 2063--- was there a concerted effort to change the current practice and its reliance upon the living liver donor.