Background: Liver transplantation (LT) recipients frequently develop complication kidney dysfunction (KD), but the predisposing factors and long-term consequences of KD are not well understood. Post-LT complications that lead to graft failure and patient morbidity/mortality can be generally categorized as vascular, biliary, parenchymal and malignant. Main reasons for our study are to identify complications’ rate for early post-transplant KD and to evaluate the post-LT patients and graft survival rate. Aim: Our aim was to evaluate complications in recipients with early post-transplant KD and to investigate the survival rate after LT. Material and Methods: This study retrospectively and prospectively analyzed the demographic characteristics, preoperative and perioperative clinical parameters, as well as postoperative outcomes of patients who underwent liver transplantation (LT) at the First Central Hospital of Mongolia (FCHM) between September 2011 and December 2024. Renal function was evaluated by estimating the glomerular filtration rate (GFR) using the Cockcroft-Gault creatinine clearance formula at baseline (pre-transplantation) and at 24 hours, 72 hours, 7 days, 14 days, and 28 days following LT. Early and late complications following LT were classified according to the international classification. Ethical approval for the study was obtained at a meeting of the Research Ethics Review Board of the Mongolian National University of Medical Sciences (MNUMS). Results: In our study KD rate was 29.7%. Several factors increased the risk of KD among recipients. Post-LT complications’ related risk factors for KD was high MELD score (OR, 1.11; 95%CI, 1.06-1.16), Child-Turcotte-Pugh scores of B and C (OR, 5.57; 95%CI, 1.27-24.52 and OR, 8.21; 95%CI, 1.87–36.54), comorbidities (OR, 1.92; 95%CI, 1.14-3.23), post-LT acute bleeding (OR, 3.22; 95%CI, 1.22-8.46), early relaparotomy for revision (OR, 3.12; 95%CI, 1.34-7.28 respectively. Additionally, the survival rates for recipients with post-LT KD were 90.7% at 1 year and 81.3% at 3 years. Conclusions 1. Variables like a recipient high age (p<0.001), female gender (p<0.001), elevated liver function scores (p<0.002), comorbidities (p=0.013), severe ascites (p=0.001), preop intensive care (p=0.026) are pre-LT risk factors for post- LT KD. 2. Acute bleeding (p=0.013), early revision (p=0.006) are risk factors for post-LT KD. 3. Early KD in recipients who underwent LT affects both patient survival (Log Rank p=0.522; HR 1.3) and graft survival (Log Rank p=0.457; HR 1.26).

Emergency cesarean section risk factors of Robson 1, 2A, 3, 4A Introduction: Cesarean section rates in Mongolia exceed WHO recommendations of 5–15%, reaching 27.6% nationally and 34.1% at the First Maternity Hospital between 2019–2023. C-sections, while life-saving, increase risks of hemorrhage, infection, uterine complications, and reduced maternal quality of life. This study aimed to analyze emergency C-sections by Robson classification and identify associated risk factors in groups 1, 2a, 3, and 4a. Material and methods: A retrospective case-control study was conducted using 886 medical records (443 emergency C-sections and 443 vaginal deliveries) from 2021–2023. Data were analyzed with IBM SPSS 24.0, and binary logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Results: Robson 2a was the most frequent category (43.8%), followed by 4a (25.7%), 1 (20.1%), and 3 (10.4%). Significant risk factors for emergency C-section included maternal age (p<0.001), early cervical dilation (<5 cm) at labor diagnosis (OR 3.54), abnormal CTG, pre-eclampsia, PROM, amniotomy, infertility, and malposition. Multivariate analysis showed PROM (aOR 14.66), amniotomy (aOR 6.85), fetal weight ≥4000 g (aOR 4.07), and maternal age (aOR 1.48) as key predictors. Conclusions: Emergency C-sections were most common in Robson group 2a. Major contributing factors included PROM, amniotomy, maternal age, macrosomia, and abnormal labor patterns. Targeted interventions to manage these risk factors could reduce unnecessary emergency C-sections.

Introduction: A considerable proportionof adult living donor liver transplantation(LDLT) recipients experience biliarycomplication (BC), but there are few reportsregarding BC based on long-term studies ofa large LDLT population.Methods: The present study examinedBC incidence, from 16 adult and pediatricpatients (14 right liver and 2 left liver graft )between 2011 and 2016 First Central Hospitalof Mongolia.Results: The mean follow-up period was36±1 months. First Central Hospital has DDanastmosis (n=22) double DD (n=2) singlehepaticojejunostomy (n=3). There 3 caseshave biliary stricture after operation. One ofthe 3 cases has biliary laek 2 months laterafter the operation.Conclusion: Close surveillance for BCappears necessary for at least the first 3 yrafter LDLT. In terms of anastomotic stenosisrisk, HJ appears a better choice than DD forright liver grafts involving ducts less than 4mm in diameter.

Introduction: Biliary Atresia is a fibroobliterativedisorder of the intra andextrahepatic bile ducts in infancy, which isgoing progressively cholestatic liver disease.The failed Kasaiportoenterostomy requiresliver transplantation. The goal of this studyis to show the outcome of Kasai operation,recent improvement and correlation the datato overseas.Methods and Materials: This study wasconducted in the department of generalsurgery of National Center for Maternal andChild Health of Mongolia between 2010 and2016 on a total of 66 infancies with biliaryatresia.Results: Patient diagnosed with biliaryatresia, which performed Kasai operationwithin first 2 months the outcome is verygood early and late post-operation period.There were 3 patients with 10 year survival, 4patients with 5-10 year and 28 patients with5 year survival after Kasai operation. The mostcomport age for liver transplantation is 1 yearlater after Kasai operation in Mongolia. Livertransplantation programme is necessary forMongolian pediatric surgery, and we thoughtour team was assembled.Conclusion: The children with biliary atresiaperform the Kasai operation within 2 monthsthe outcome is very good. Children with biliaryatresia often experience long wait times fortransplant unless exception points are grantedto reflect severity of disease.In Mongolia livertransplantation done in 2 child.