New criteria for liver transplantation in adults: the combined Groningen and Rotterdam protocol

A combined protocol for liver transplantation has been written by the teams of Groningen and Rotterdam. This is to ensure that the criteria for selection and timing of liver transplantation, and the procedures for patient evaluation, are identical or at least very similar. Also, the waiting list procedures in the two centres, including the criteria used to decide which patient will be transplanted first, are very similar.

Currently, most patients with liver cirrhosis or filminant liver failure should be considered as liver transplant candidates unless a contraindication is found. Most contraindications are relative and are the subject of a careful balance of pros and cons. The detection and care of liver patients starts with the general practitioner. Referral to liver transplantation centres is the final step. In the Netherlands, liver disease is relatively rare and therefore patients are best serveed when the expertise is concentrated in a few liver centres. (C) 1998 Elsevier Science B.V.