Liver transplantation: the Italian experience.
Liver transplantation is the standard treatment for patients with end-stage liver disease no longer responsive to conventional medical treatment



To report the long-term experience of liver transplantation in Italy.



Data were obtained retrospectively by means of a multiple-item form collected from 15 Italian liver transplant centres. The filing centre was centralized.



A total of 3323 liver transplants were performed on 3026 patients, with a cumulative proportional survival of 72.4%. Three, 5 and 10 years' patient survival rates were 72.3%, 68.8% and 61.3%, respectively. The most common indication for liver transplantation were hepatitis B virus (+/- hepatitis D virus)- and hepatitis C virus-related cirrhosis (59.4%). Excellent survival rates were observed particularly in controversial indications, such as alcoholic cirrhosis, hepatitis B virus-related cirrhosis and hepatocellular carcinoma. Retransplantation was required in 8.9% of the cases. The overall prevalence of acute cellular rejection episodes was 43.5%. In our study population, primary non-function and disease recurrence were the most common causes of graft failure (28.7% and 25.4%, respectively). Infections and/or sepsis were the most common causes of death after transplantation (42%).



This study confirms that patients with controversial indications to liver transplantation such as alcoholic cirrhosis, HBV-related cirrhosis and hepatocellular carcinoma can achieve excellent survival when properly selected.
Fagiuoli
S
S
Surgical and Gastroenterological Sciences Department, University Hospital of Padua, Italy. fagiuoli@unipd.it
Mirante
V G
VG
Pompili
M
M
Gianni
S
S
Leandro
G
G
Rapaccini
G L
GL
Gasbarrini
A
A
Naccarato
R
R
Pagliaro
L
L
Rizzetto
M
M
Gasbarrini
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008107:Liver Diseases / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D015995:Prevalence; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate