Fatigue after Liver Transplantation

textabstractLiver transplantation (LTx) has developed from an experimental procedure in the 1960’s to the preferred treatment for end-stage liver disease nowadays. The first human LTx was performed by Starlz and his team in 1963 in Colorado.[1] Unfortunately, this patient died within a few days. The first successful LTx was performed in 1967 by the same team; this patient survived one year. The most prevalent indications for LTx in Europe are virus-related cirrhosis (22%), alcoholic cirrhosis (19%), cancer (18%), cholestatic liver diseases (11%), acute hepatic failure (9%) and metabolic disease (6%).[2] The main complications in the immediate postoperative period are dysfunction and rejection of the graft, infections, bile duct complications and pulmonary or neurological problems. Long-term complications after LTx are typically a consequence of the prolonged immunosuppressive therapy, and include diabetes mellitus, infections, renal dysfunction, hypertension, osteoporosis, and de novo neoplasia.[3] Currently, three University Medical Centers are performing LTx’s in the Netherlands: Groningen, Leiden and Rotterdam