Liver Transplantation

What is Liver Transplantation?

• A liver transplant removes a liver no longer functioning properly due to chronic (end-stage chronic liver disease) or sudden, acute liver failure, replacing it with a healthy liver from a deceased donor or part of a healthy liver from a matching living donor. Liver transplantation is also a treatment option for other conditions, including some forms of liver cancer.

• The first successful liver transplant took place in 1967.

• Major reasons for liver transplantation include metabolic dysfunction-associated steatohepatitis (MASH); alcohol-associated liver disease; liver cancer (hepatocellular carcinoma (HCC)); bile duct cancer (cholangiocarcinoma); autoimmune hepatitis; primary biliary cholangitis, primary sclerosing cholangitis, Hepatitis B and C; acute liver failure; biliary atresia (children).

• Major causes of cirrhosis leading to liver failure and liver transplantation include alcohol-associated liver disease; MASH; hepatitis B and C; genetic diseases (e.g., hemochromatosis, Wilson's disease, alpha-1 antitrypsin); autoimmune hepatitis; diseases that affect bile ducts (e.g., primary biliary cirrhosis, primary sclerosing cholangitis, biliary atresia).

• Alcohol-associated liver disease and metabolic dysfunction-associated hepatitis are the most common reasons for liver transplantation among adults.

• Biliary atresia is the most common reason for liver transplantation among children.

• In 2024, there were 11,458 liver transplants in the US: 10,854 from deceased donors, 604 from living donors.

• There are currently 9,065 people on the liver transplant waitlist. (June 2025).

• There are more people who need a liver than the supply available. People continue to die while on the waiting list.

• Only a small percentage of liver transplants each year are from living donors.

• Liver transplants have grown among adolescents/young adults.

• In the past decade, there has been a 25 percent increase in liver transplants in children 11 to 17 years old; transplants for young adults 18 to 34 more than doubled (United Network for Organ Sharing; UNOS).

• The waiting time for a deceased donor liver transplant ranges from less than 30 days to more than 5 years. One source places the average wait time at 11 months.

• Of adults added to the liver waiting list (2021): 39.9% received a deceased donor liver transplant within 3 months; 45.7%, within 6 months; and 54.5%, within 1 year.

• Waitlist candidates by sex distribution (2023): 60.6% male; 39.4% female.

• Female liver transplant waitlist candidates had higher pretransplant mortality rates than male candidates (2023).

• Racial and ethnic composition of liver waitlist candidates (2023): 67.8% White, 19.0% Hispanic/Latino, 6.5% Black/African American, 4.5% Asian, 1.2% Native American, 0.6% Multiracial, and 0.3% unreported.

• Racial and ethnic composition of liver transplant recipients (2023): 69.8% White, 17.5% Hispanic/Latino, 6.6% Black/African American, 4.1% Asian, 0.6% Multiracial, and 0.4% unreported.

• Liver transplants by age (2023): 6.3% age 18-34 years; 20.1% 35-49 years; 46.7% 50-64 years; 26.9% 65 years or older.

• There are good trends in liver transplantation that need to continue:
  • In 2023, the number of liver transplants performed in the US reached another record high: 10,659 overall, of which 10,125 (95.0%) were in adult recipients and 534 (5.0%) were in pediatric recipients.
    There was also growth in living donation: 5.7% of adult transplants and 14.6% of pediatric transplants were from living donors.
  • Wait times are shorter.

• About 75%-78% of people receiving a liver transplant live for at least five years and nearly 65% after 10 years.

• Survival rates can depend on age, overall health, and the original disease that made the transplant necessary (some diseases return or continue).

• Recipients have been known to live a normal life more than 30 years after the transplant operation.

• Because there are many more people who need a new liver than there are livers available for those people, researchers are looking for ways to increase the number of livers available for patients.

• Liver machine perfusion technology was developed to expand the number of livers available for transplantation.

• In 2024, Penn Medicine performed the first successful external liver perfusion with a gene-edited pig liver. Blood in a brain-dead patient was circulated through a gene-edited pig’s liver that was outside the body. The pig’s liver showed no signs of inflammation for 72 hours during the test and the body remained stable.

• Researchers have had successes with gene-edited pig kidneys and hearts, but liver transplants have proven more complicated.

• This may be one solution to the shortage of livers for transplantation.

• Recently, a gene-edited pig liver was transplanted into a brain-dead patient in China, functioning for 10 days; there were no signs of immune rejection or accumulation of inflammation.

Last updated on December 10th, 2025 at 04:35 pm