[The demographic, perioperative and mortality characteristics of the Hungarian Liver Transplant Program].
BACKGROUND
The authors summarize the demographic, morbidity and mortality characteristics of the Hungarian Liver Transplant Program.


OBJECTIVE
They evaluate the changes and development, that has taken place with regard to indications, recipient population and characteristics, operation technique, and peroperative patient management.


METHODS
In order to present the development, data are compared between two time periods (before and after 1999). The results are summarized on Tables and statistical Figures. Categorical variables are evaluated by chi2-test, continuous ones are with Levene Test (for homogeneity of means), Student T test and Mann-Whitney U-test. Cumulative survivals are computed with Kaplan-Meier log rank analysis.


RESULTS
194 primary liver transplantation have been performed. The hepatitis C was the leading indication from the beginning. Ten (10) liver transplantation have been performed in 1995, while 44 in 2004. The mortality within the first 2 months decreased from 24% to 5%. The 1, 3 and 5 year cumulative patient survival increased from 55%, 45% es 39% (1995-1997), to 72%, 64% es 61% (1998-2000). Recently this is 78%, 77% es 77%.


CONCLUSIONS
Between 1995-1997 conventional liver transplantation became standard, while piggy back turned to be popular from 1998. From 1999 the HCV-PCR monitoring, the combined antiviral treatment, the UW perfusion of the donors took place. From 2003 we introduced the tailored immunosuppression, the steroid-free protocol for viral diseases. Total infused volume was decreased together with the amount of transfusion. The retrograde graft reperfusion (from the caval side) was introduced in 2004 together with the split technique in the liver transplantation and the rebirth of the pediatric program. The overall outcome of the retrospective analysis is, that the program has been developed to European standards with respect to its volume, technical capabilities and results.
Nemes
Balázs
B
Semmelweis Egyetem, Altalános Orvostudományi Kar, Transzplantációs es Sebészeti Klinika, Budapest. nemes@trans.sote.hu
Sárváry
Eniko
E
Kóbori
László
L
Gerlei
Zsuzsa
Z
Fehérvári
Imre
I
Görög
Dénes
D
Perner
Ferenc
F
Ther
Gábor
G
Varga
Marina
M
Szonyi
László
L
Telegdy
László
L
Schuller
János
J
Weszelits
Viola
V
Járay
Jeno
J
D000293:Adolescent; D000328:Adult; D019072:Antibiotic Prophylaxis / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007165:Immunosuppression Therapy / Q000379:methods; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D012189:Retrospective Studies; D015996:Survival Rate; D019172:Transplantation Conditioning