title: Liver transplant for 70 patients with end-stage liver diseases.
abstract: BACKGROUND
  Liver transplantation has evolved as a successful treatment for patients with end-stage liver cirrhosis and acute liver failure. Postoperative survival rates have increased to 90% in 1 year and 80% in 5 years as a result of improvements in immunosuppression, perioperative management and surgical techniques. However, a wide range of postoperative complications are of technical or medical origin. This study was undertaken to determine the relationship between the technical improvements and optimal timing of surgery and its outcome.
  
  
  METHODS
  From April 1999 to October 2005, typical orthotopic or piggyback liver transplantation was performed in 70 patients (58 men and 12 women, aged 19-74 years). Twenty-four patients had liver carcinoma and cirrhosis, and 46 had benign liver disease.
  
  
  RESULTS
  All patients survived the operation and 14 died in the first month after surgery because of respiratory failure (6), respiratory failure accompanied by acute renal failure (4), intra-abdominal hemorrhage and infection (2), and cerebral edema (2). A total of 76 complications occurred in the 70 patients after operation: pneumonia (34), right pleural effusion (11), bile leakage (7), postoperative intra-abdominal hemorrhage and infection (4), acute renal failure (4), acute rejection (3), wound infection (2), biliary tract stenosis (2), severe cholangitis derived from cholelith (2), morphological alteration of biliary tree (2), cerebral edema (2), empyema (1), chronic rejection (1), and wound hematoma (1). Finally, 33 patients survived more than 6 months, 16 more than 1 year, 4 more than 2 years, and 2 more than 6 years after operation. The perioperative survival rate was 80% in this series.
  
  
  CONCLUSIONS
  Liver transplantation is an effective treatment for patients with end-stage liver disease. To obtain good results, improvements of surgical technique, optimal timing and better postoperative care are needed.
authors.affiliation: Centre of Hepatobiliary Surgery, Fuzhou General Hospital, Fuzhou 350025, China. jiangyi183@yahoo.com.cn
authors.forename: Yi
authors.initials: Y
authors.lastname: Jiang
authors.forename: Li-Zhi
authors.initials: LZ
authors.lastname: Lv
authors.forename: Qiu-Cheng
authors.initials: QC
authors.lastname: Cai
authors.forename: Kun
authors.initials: K
authors.lastname: Zhang
authors.forename: Huan-Zhang
authors.initials: HZ
authors.lastname: Hu
authors.forename: Shao-Geng
authors.initials: SG
authors.lastname: Zhang
authors.forename: Fang
authors.initials: F
authors.lastname: Yang
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Wei
authors.forename: Xiao-Jin
authors.initials: XJ
authors.lastname: Zhang
authors.forename: Yong-Biao
authors.initials: YB
authors.lastname: Chen
authors.forename: Fan
authors.initials: F
authors.lastname: Pan
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D019164:Liver, Artificial; D008297:Male; D008875:Middle Aged; D011379:Prognosis