Evolution of living donor liver transplantation in Egypt.
OBJECTIVE
To date, cadaveric organ donation is illegal in Egypt. Therefore, Egypt recently introduced living donor liver transplantation (LDLT), aiming to save those who are suffering from end stage liver disease. Herein, we study the evolution of LDLT in Egypt.


METHODS
In Egypt, between August 2001 and February 2004, we approached all centers performing LDLT through personal communication and sent a questionnaire to each center asking for limited information regarding their LDLT experience.


RESULTS
We identified and approached 7 LDLT centers, which collectively performed a total of 130 LDLT procedures, however, 3 major centers performed most of the cases (91%). Overseas surgical teams, mainly from Japan, France, Korea, and Germany, either performed or supervised almost all procedures. Out of those 7 LDLT centers, 5 centers agreed to provide complete data on their patients including a total of 73 LDLT procedures. Out of those 73 recipients, 50 (68.5%) survived after a median follow-up period of 305 days (range 15-826 days). They reported single donor mortality. Hepatitis C virus cirrhosis, whether alone or mixed with schistosomiasis, was the main indication for LDLT.


CONCLUSIONS
Egypt recently introduced LDLT with reasonable outcomes; yet, it carries considerable risks to healthy donors, it lacks cadaveric back up, and is not feasible for all patients. We hope that the initial success in LDLT will not deter the efforts to legalize cadaveric organ donation in Egypt.
Khalaf
Hatem
H
Department of Liver Transplantation and Hepatobiliary-Pancreatic Surgery MBC-72, King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh 11211, Kingdom of Saudi Arabia. hatem_khalaf@hotmail.com
El-Meteini
Mahmoud
M
El-Sefi
Talaat
T
Hamza
Alaa F
AF
El-Gazaz
Galal
G
Saleh
Saleh M
SM
Moustafa
Ibrahim
I
Gad
Hesham
H
Yosry
Ayman
A
El-Hussainy
Ehab
E
Khafaga
Medhat
M
Helmy
Amr
A
D003466:Cultural Characteristics; D003695:Delivery of Health Care; D003906:Developing Countries; D004534:Egypt; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007258:Informed Consent; D017093:Liver Failure / Q000208:ethnology / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000208:ethnology* / Q000639:trends; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D016896:Treatment Outcome