title: Evolution of living donor liver transplantation in Egypt.
abstract: 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.
authors.affiliation: 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
authors.forename: Hatem
authors.initials: H
authors.lastname: Khalaf
authors.forename: Mahmoud
authors.initials: M
authors.lastname: El-Meteini
authors.forename: Talaat
authors.initials: T
authors.lastname: El-Sefi
authors.forename: Alaa F
authors.initials: AF
authors.lastname: Hamza
authors.forename: Galal
authors.initials: G
authors.lastname: El-Gazaz
authors.forename: Saleh M
authors.initials: SM
authors.lastname: Saleh
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Moustafa
authors.forename: Hesham
authors.initials: H
authors.lastname: Gad
authors.forename: Ayman
authors.initials: A
authors.lastname: Yosry
authors.forename: Ehab
authors.initials: E
authors.lastname: El-Hussainy
authors.forename: Medhat
authors.initials: M
authors.lastname: Khafaga
authors.forename: Amr
authors.initials: A
authors.lastname: Helmy
mesh_terms: 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