[Liver transplantation--present status worldwide and in the Czech Republic].
Since 1983 liver transplantation (LT) has been accepted as clinical method of treatment, namely of patients with "end stage liver disease", it is patients with the incurable phase of liver disease which excludes spontaneous recovery or successful conservation therapy, but which is not the terminal state. Patients, indicated for LT should be therefore in generally good condition, but with a prospect of survival with conservative treatment lower than one year. The most frequent indication in adults is the hepatic failure resulting from viral hepatitis and cholestatic diseases. In children younger than 2 years it is atresia of biliary ducts, in older children metabolic diseases and fulminant failure predominate. Children with secondary liver impairment resulting from a cystoid fibrosis or a hepatic malignancy are recommended for LT only rarely. About 8000 liver transplantations are performed annually in the world, about one sixth is in child recipients. Contrary to LT in adults, such operation in children has several risk moments. The liver splitting or grafting of a hepatic segment from a living relative donor belongs to the most complicated surgical techniques. At the end of nineties, in the advanced centers, one-year survival reached 85 to 90% with high probability of improving quality of life. In the Czech Republic 60 to 70 liver transplantations are performed annually in two centers (Prague, Brno) with comparable results.
Ryska
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Klinika transplantacní chirurgie Transplantcentrum IKEM, Praha. miry@medicon.cz
Trunecka
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D000328:Adult; D018153:Czech Republic; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data