[One thousand liver transplants. Hospital Clinic i Provincial de Barcelona (Spain)].
The aim of this study was to evaluate a consecutive series of 1000 liver transplants performed in our institution and to evaluate changes over time in donors and recipients, as well as results.


METHODS
To clearly evaluate the differences between the initial transplantation period and the present period, the first 100 consecutive liver transplantations performed (June 1988-June 1990) and the last 200 consecutive liver transplantations performed (January 2001-June 2003) were compared.


RESULTS
Donor age increased (23+/-10 vs. 45+/-19), the etiology of brain death changed (severe head injury: 78% vs. 23.5%; stroke: 17% vs. 52.5%) and the percentage of donors from alternative methods to cadaveric donors increased (living donors: 12.5%) in the second period. Regarding recipients, the piggy-back technique and biliary anastomosis without T-tube were introduced in the second period. Actuarial 1-year survival was higher in the second period than in the first (84% vs. 91.3%). The need for retrasplantation in the entire series was 9.5%, with actuarial survival at 1, 5 and 10 years of 67.7%, 51.3% and 39.4%, respectively.


CONCLUSIONS
Because of the lack of donors and the greater number of patients on the waiting list, poorer quality donors and more critical recipients have been accepted and alternative and innovative programs have been started. Nevertheless, due to improvement in patient management before, during and after transplantation, the previous good results have been maintained.
Amador
Auxiliadora
A
Servicio de Cirugía General y Aparato Digestivo, Instituto de Enfermedades Digestivas, Hospital Clínic i Provincial, Barcelona, Spain. 32504aam@comb.es
Charco
Ramón
R
Martí
Josep
J
Ferrer
Joana
J
Mans
Esther
E
Fondevila
Constantino
C
Fuster
Josep
J
Visa
Josep
J
Rimola
Antoni
A
Navasa
Miguel
M
García-Valdecasas
Juan Carlos
JC
Grande
Luis
L
D000328:Adult; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013030:Spain; D015996:Survival Rate; D014019:Tissue Donors