The Collaborative Transplant Study (CTS) has collected background clinical as well as outcome data on liver transplants since 1985. Data on nearly 80,000 liver transplantations have been recorded and are currently available for analysis. Analysis of the evolution of liver transplant results over time as well as interesting comparisons with kidney, heart, lung and pancreas transplantation are possible. Outcome analysis shows an impressive improvement of the success rate of liver transplantation. However, unlike the results of kidney transplantation, which have improved both in the short- and long-term, liver transplant results show a significant short-term improvement during the early post-transplant period only. The long-term attrition rate, best expressed as long-term half-live, has remained virtually unchanged for many years.

We will discuss how the introduction of the MELD score for donor liver allocation has had undesired effects in at least one country. Disease-specific survival rates as well as the influence of different immunosuppressive drug strategies and immunogenetic factors will be discussed as well.