Quality of life vastly improved for most patients

The prospects for most people who have liver transplants are good. Nine in 10 recipients are alive a year after the operation and five-year survival rates are between 70% and 85%, but there is a big shortage of donors, and ideally the organs should come from people under 50.

The best donors for children are children of about the same age.

For the past five years, only 650-680 transplants a year have been performed in Britain, despite the expertise gained since the first operation in the UK in 1968. There are 130-150 people waiting for the operation at any one time.

The liver is remarkably tolerant of abuse, whether due to alcohol - by far the main culprit for serious disease - hepatitis or other illnesses, but transplant of the organ, effectively the body's sewage plant, is sometimes the only option.

More recently, split-liver transplants have been undertaken, where a live donor can give part of his or her liver to another patient. The remaining tissue regenerates.

A whole transplant is a complicated procedure. Most operations take at least eight hours and sometimes much longer. The diseased liver is removed and connections have to be made between the new organ and the portal vein, which carries blood from the intestine, as well as arteries supplying the liver with blood and the intestine for the bile duct.

There are risks. The donated liver may not function. There may be an early acute rejection by the body's immune system. A short course of steroids can usually treat this, although all transplant patients will have to take anti-rejection tablets for the rest of their lives. Most deaths from rejection occur within three months of the operation.

Chronic rejection, development of hepatitis in the new liver, or any obstruction to the flow of bile can also bring serious problems, sometimes requiring a second transplant.

Many patients are discharged from hospital after about three or four weeks. Most then lead a normal life and, in almost all cases, the quality of life is hugely improved.