title: Orthotopic liver transplantation at Groote Schuur Hospital.
abstract: We present data on 10 patients (5 men and 5 women, aged 21-56 yrs) with end-stage liver disease or tumour who underwent orthotopic liver transplantation at Groote Schuur Hospital between October 1988 and June 1991. Standard surgical techniques were used for procuring the donor liver, the recipient hepatectomy and the implantation of the liver. The venovenous bypass method was used in all but 2 patients. Postoperative immunosuppression was usually achieved with cyclosporin, azathioprine and low-dose steroids. Six patients were treated with prophylactic OKT3. Rejection episodes were treated with bolus doses of intravenous steroids. The indications for liver transplantation included chronic active hepatitis progressing to cirrhosis (5), biliary cirrhosis in association with inflammatory bowel disease (1), sclerosing cholangitis (2), alpha 1-antitrypsin deficiency (1), and tumour (1). All patients with chronic liver disease had experienced at least one complication, examples of which included encephalopathy, bacterial peritonitis, ascites, variceal bleeding and septicaemia. Serious postoperative complications included acute rejection of the transplanted liver, renal and liver failure that responded to intensive care support and medical management. One patient died on the 11th postoperative day with complications of bleeding oesophageal ulcer, shock and fungaemia. The remaining patients are alive and well 1-31 months after transplantation.
authors.affiliation: University of Cape Town.
authors.forename: S C
authors.initials: SC
authors.lastname: Robson
authors.forename: C W
authors.initials: CW
authors.lastname: Spearman
authors.forename: M F
authors.initials: MF
authors.lastname: James
authors.forename: P
authors.initials: P
authors.lastname: Gordon
authors.forename: L
authors.initials: L
authors.lastname: Michell
authors.forename: K
authors.initials: K
authors.lastname: Jaskiewicz
authors.forename: P
authors.initials: P
authors.lastname: Jacobs
authors.forename: M D
authors.initials: MD
authors.lastname: Voigt
authors.forename: R
authors.initials: R
authors.lastname: Hickman
authors.forename: R E
authors.initials: RE
authors.lastname: Kirsch
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D008107:Liver Diseases / Q000601:surgery; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D013019:South Africa; D009927:Tissue and Organ Procurement
chemical_list: D000900:Anti-Bacterial Agents