The Baylor Regional Transplant Institute: review of a twenty-year experience.

As the Baylor Regional Transplant Institute celebrates its 20-year anniversary and the transplant of its 2,500th liver, the program has continued to grow, reaching its highest yearly volume to date. Twenty years gives an excellent opportunity to see how the facets of our program have adjusted in response to changes in both society and our own field of transplantation. Our recipient and donor demographics have changed significantly, but despite older recipients, older and more marginal donors and the issues of disease recurrence, we have consistently improved survival of both the patient and graft, reduced rejection rates and minimized hospital and ICU stays. These survival improvements have been even more pronounced in patients transplanted for HCC. Because of constantly changing risk and complication patterns, we have continually analyzed and adapted our processes and protocols, adjusting them in response to patient outcomes and the best current scientific evidence when needed. The research at Baylor has always had a practical, clinical dimension, but with development of our "Genes of Health" program at the Baylor Institute of Immunology Research, we hope to expand more basic science transplant research and most importantly take the lead in translational research.