AFTER 20 YEARS as an experimental procedure, ortho-

topic liver transplantation for patients with advanced he-patic disease has come of age (1, 2). Survival statistics from the four centers with the most experience suggest that the 1-year survival for children having a hepatic transplant should exceed 70%, whereas that for adults should exceed 50 % and may, with more care given to the choice of candidates and experience, approach the level of success being achieved in children (3-7). Late deaths among transplant recipients occurring after the first year of survival are unusual and attrition after 1 year of sur-vival actually approaches that seen in the general popula-tion (2). The longest known living hepatic transplant survivor is alive, 15 years after the original procedure. Encouraged by these results, several hepatic transplan-tation programs have been started or reopened. In the United States, in addition to the program at the Universi-ty of Pittsburgh, liver transplantation programs presentl