title: Liver transplantation. Experience with 100 cases.
abstract: Between March 1988 and November 1989, 100 liver transplants were performed on 90 patients at Pacific Presbyterian (now California Pacific) Medical Center in San Francisco. The immunosuppressive regimen was a combination of prophylactic Minnesota antilymphocyte globulin, cyclosporine, and low-dose corticosteroids. Rejections were treated with OKT3, a monoclonal antibody, or corticosteroids. Of the 100 transplants, 32 were done on 30 children, 18 of whom weighed less than 10 kg and 9 of whom received livers that had been surgically reduced in size to fit the recipient. The overall patient survival at 2 years was 85%. Of 100 liver transplants, treatment was given for 80 (80%) for at least 1 episode of rejection. At least 1 episode of serious infection occurred in 34 of the 60 adult patients and 25 of the 30 children. Of the entire group, 2% had hepatic artery thrombosis, and 12% had biliary complications that necessitated reoperation. The quality of life has been good, with a follow-up from 1 to almost 3 years (mean = 22 months). Comparing these data with those of other published series shows a decreased incidence of surgical complications and a lower rate of fungal and viral infections. We attribute this to the reduction of steroid dosage during convalescence without jeopardizing patient or graft survival.
authors.affiliation: Transplant Institute, California Pacific Medical Center, San Francisco.
authors.forename: J L
authors.initials: JL
authors.lastname: Szpakowski
authors.forename: K
authors.initials: K
authors.lastname: Cox
authors.forename: P
authors.initials: P
authors.lastname: Nakazato
authors.forename: W
authors.initials: W
authors.lastname: Concepcion
authors.forename: B
authors.initials: B
authors.lastname: Levin
authors.forename: C O
authors.initials: CO
authors.lastname: Esquivel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011788:Quality of Life; D012086:Reoperation; D015996:Survival Rate