Balanced approach can help initial outcomes: analysis of initial 50 cases of a new liver transplantation program in East Asia.
10.4174/astr.2014.87.1.22
- Author:
Dong Sik KIM
1
;
Young Dong YU
;
Sung Won JUNG
;
Kyung Sook YANG
;
Yeon Seok SEO
;
Soon Ho UM
;
Sung Ock SUH
Author Information
1. Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea. kimds1@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Liver transplantation;
Donor selection;
Liver transplantation program;
Outcome;
Survival
- MeSH:
Asian Continental Ancestry Group;
Carcinoma, Hepatocellular;
Donor Selection;
Far East*;
Follow-Up Studies;
Graft Survival;
Humans;
Liver;
Liver Diseases;
Liver Transplantation*;
Living Donors;
Medical Records;
Mortality;
Retrospective Studies;
Survival Rate;
Tissue Donors;
Triage;
Waiting Lists
- From:Annals of Surgical Treatment and Research
2014;87(1):22-27
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate patient triage pattern and outcomes according to types of liver transplantation as part of a new liver transplant program developed in an East Asian country with a limited number of deceased donors. METHODS: Medical records of initial 50 liver transplantations were reviewed retrospectively. RESULTS: Twenty-nine patients underwent deceased donor liver transplantation (DDLT) and 21 patients underwent living donor liver transplantation (LDLT). Mean model for end-stage liver disease scores of recipients of DDLT and LDLT were 24.9 +/- 11.6 and 13.1 +/- 5.4, respectively (P < 0.0001). Twenty-eight patients had HCCs and 17 of them (60.7%) underwent LDLT, which was 80.9% of LDLTs. There were 2 cases of perioperative mortality; each was from DDLT and LDLT, respectively. Median follow-up was 18 months. Overall patient and graft survival rates at 6 months, 1 and 2 years were 95.7%, 93.4%, and 89.8%, respectively. There was no significant difference in survival between DDLT and LDLT. Overall recurrence-free survival rates of hepatocellular carcinoma (HCC) patients at 6 month, 1, and 2 years were 96.3%, 96.3%, and 90.3%, respectively. There was no significant difference in recurrence-free survival between DDLT and LDLT. CONCLUSION: As a new liver transplant program with limited resource and waiting list, patients with critical condition could undergo DDLT whereas relatively stable patients with HCCs were mostly directed to LDLT. We recommend a balanced approach between DDLT and LDLT for initiating liver transplant programs.
