Twelve years of liver transplantation at the Mayo Clinic.

During the past 12 years, the Mayo Clinic Liver Transplant Program has continued to flourish. Not only has the program steadily grown in the numbers of patients transplanted, but now we are achieving an overall 90% one-year survival rate and have reduced our median posttransplant hospital stay to 9 days. Furthermore, a protocolized approach to the procedure has allowed us to continuously evaluate the appropriate use of resources and has allowed us to decrease the use of certain laboratory tests, reduce the use of radiologic and invasive procedures, and improve the overall cost efficiency. The challenge of the future will be to deal with recurrent disease and retransplantation. We desperately need treatment to prevent the recurrence of hepatitis B and C and, finally, we continue to search for immunosuppressive therapies that are less toxic and less costly.