Liver transplant for 70 patients with end-stage liver diseases.
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.
Jiang
Yi
Y
Centre of Hepatobiliary Surgery, Fuzhou General Hospital, Fuzhou 350025, China. jiangyi183@yahoo.com.cn
Lv
Li-Zhi
LZ
Cai
Qiu-Cheng
QC
Zhang
Kun
K
Hu
Huan-Zhang
HZ
Zhang
Shao-Geng
SG
Yang
Fang
F
Wei
Wei-Ming
WM
Zhang
Xiao-Jin
XJ
Chen
Yong-Biao
YB
Pan
Fan
F
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