Orthotopic
liver transplantation remains the only curative treatment for many end-stage
liver diseases, yet the number of patients receiving
liver transplants remains limited by the number of organs available for transplant. There is a need for
alternative therapies for
liver diseases. The
transplantation of isolated hepatocytes (liver cells) has been used as an
experimental therapy for
liver disease in a limited number of cases. Recently, the 100th case of hepatocyte
transplantation was reported. This review discusses the history of the hepatocyte transplant field, the major discoveries that supported and enabled the first hepatocyte transplants, and reviews the cases and outcomes of the first 100 clinical transplants. Some of the problems that limit the application or efficacy of hepatocyte
transplantation are discussed, as are possible solutions to these problems. In conclusion, hepatocyte transplants have proven effective particularly in cases of metabolic
liver disease where reversal or amelioration of the characteristic symptoms of the disease is easily quantified. However, no patients have been completely corrected of a metabolic
liver disease for a significant amount of time by hepatocyte
transplantation alone. It is likely that future developments in new sources of cells for
transplantation will be required before this cellular
therapy can be fully implemented and available for large numbers of patients.