One thousand liver transplants: the hospital clinic experience.
OBJECTIVE
Our goal was to study a consecutive series of 1000 liver transplants performed in our institution to evaluate the changes over time in donors, recipients, and results.


METHODS
With the aim to evaluate differences between transplantation in the first period and the present period, the first consecutive 100 liver transplants performed from June 1988 to June 1990 (first period) were compared with the last consecutive 200 liver transplants performed from January 2001 to June 2003 (second period).


RESULTS
Increased donor age, change in donor cerebral death etiology, and increasing numbers of grafts from alternative methods using cadaveric donors were observed in the second period. Piggy-back technique and the biliary anastomosis without a t-tube was also started in the second period. One-year actuarial patient survival was higher in the second period (84% vs 91.3%). The need for retransplantation in the overall series was 95%. One-, 5-, and 10-year actuarial retransplant survival was 67.7%, 51.3%, and 39.4%, respectively.


CONCLUSIONS
Technical innovations, better understanding of donor and recipient aspects, and global improvements were the reasons for time-related improved results of liver transplantation.
Amador
A
A
Institut de Malaties Digestives i Metabólícas, Hospital Clínic i Provincial, Barcelona, Spain.
Charco
R
R
Martí
J
J
Ferrer
J
J
Mans
E
E
Fondevila
C
C
Fuster
J
J
Grande
L
L
Visa
J
J
Rimola
A
A
Navasa
M
M
García-Valdecasas
J Carlos
JC
D000328:Adult; D017677:Age Distribution; D000368:Aged; D002102:Cadaver; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D019520:Living Donors / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D020858:Tissue and Organ Harvesting / Q000379:methods