[Results of a combined adult-child liver transplantation in Switzerland].
Between July 1987 and August 1998, 173 orthotopic liver transplantations (OLT) were performed in Geneva. We studied a homogeneous group of 114 OLT performed during the 6 years between 1992 and 1997 on 107 patients (89 adults and 18 children; 7 retransplantations). Although Geneva has the largest transplantation programme in Switzerland and is the only centre performing paediatric liver transplantation, the mean number of procedures per year was 19, corresponding to only a small transplantation programme in Europe. It could be reasonably questioned, therefore, whether Swiss patients are not at a disadvantage as compared with patients from European countries with larger liver transplantation centres. Although the perioperative morbidity was still considerable, the results of this series -90% of actuarial patient survival at 1 and 2 years and 84% at 5 years-compare favourably with the results of the European Liver Transplantation Registry: 76% of actuarial patient survival at 1 year and 65% at 5 years. In this series, 95 patients (89%) were alive on January 1, 1998. As no patient was refused on the severity of the liver disease and as more than 10% of OLT were performed as emergencies, a bias due to the selection of the best cases cannot explain the good results. This series demonstrates that a small liver transplantation centre may obtain results that compare favourably with the results of large European centres, and that Swiss patients are not at a disadvantage as compared with patients of other European countries.
Mentha
G
G
Unité de transplantation, Hôpitaux Universitaires de Genève.
Le Coultre
C
C
Giostra
E
E
Belli
D
D
Huber
O
O
Rubbia-Brandt
L
L
Hadengue
A
A
Morel
P
P
D000328:Adult; D002648:Child; D005060:Europe; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D008107:Liver Diseases / Q000145:classification / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology / Q000706:statistics & numerical data*; D011183:Postoperative Complications; D012042:Registries; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D013557:Switzerland; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000458:organization & administration*