Long-term follow-up after liver transplantation in Egyptians transplanted abroad.
OBJECTIVE
To study the long-term outcome after liver transplantation (LT) in Egyptian patients who underwent LT outside Egypt.


METHODS
Between May 1993 and February 2004, over 150 Egyptians underwent LT outside Egypt. Data of 67 recipients were collected in Egypt through personal communications with the Overseas Liver Transplant Centers and through the records of the Egyptian Liver Transplant Association.


RESULTS
Most patients underwent LT in Europe (73.1%), few in the United State of America (17.9%) and in Japan (9%). Sixty-one patients underwent cadaveric LT and the remaining 6 patients underwent living related liver transplantation (LDLT). The male to female ratio was 58:9. Median age was 45 (3-63 years). Hepatitis C virus (HCV) cirrhosis whether alone or mixed with schistosomiasis was the main indication for LT. Out of those 67 recipients, 52 (77.6%) survived after a median follow-up period of 4.6 years (rang 1-10.5 years). Deaths were due to primary non-function in 3 patients, postoperative bleeding in one patient, recurrent hepatitis C virus (HCV) in 10 patients, and chronic rejection in one patient.


CONCLUSIONS
Egyptians underwent LT abroad showed a good long-term outcome. Due to the high prevalence of HCV, we expect a growing need for LT in Egypt. Although LDLT has been introduced recently in Egypt, cadaveric liver donation is still not legalized by the government. Efforts should be directed to expanding LDLT, legalizing cadaveric LT and also to the prevention and control of HCV infection in Egypt in order to avoid its devastating effect on the society as well as its enormous negative impact on Egypt's economy and future development.
Khalaf
Hatem
H
Department of Liver Transplantation and Hepatobiliary Surgery (MBC 72), King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211, Kingdom of Saudi Arabia. hatem_khalaf@hotmail.com
Farag
Sherif
S
El-Hussainy
Ehab
E
D000293:Adolescent; D000328:Adult; D002102:Cadaver; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D003431:Cross-Cultural Comparison; D004534:Egypt / Q000208:ethnology; D005060:Europe; D005260:Female; D005544:Forecasting; D019698:Hepatitis C, Chronic / Q000208:ethnology / Q000601:surgery*; D006801:Humans; D007564:Japan; D008103:Liver Cirrhosis / Q000208:ethnology / Q000401:mortality / Q000601:surgery*; D008109:Liver Diseases, Parasitic / Q000208:ethnology / Q000401:mortality / Q000601:surgery*; D017093:Liver Failure / Q000208:ethnology / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000208:ethnology* / Q000639:trends; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D011639:Public Opinion; D012552:Schistosomiasis / Q000208:ethnology / Q000401:mortality / Q000601:surgery*; D014481:United States