Outcome of foreign residents undergoing deceased donor liver transplantation in China: a single-center experience in Taiwan.
Foreign residents seeking liver transplantation in China are not uncommon. The outcomes of these people have not been well reported, and the results remain unclear. A total of 64 adults [26 with end-stage liver disease (ESLD) and 38 with hepatocellular carcinoma (HCC)] who underwent donation after cardiac death (DCD) liver transplantation in China during a 5-year period were reviewed. The median follow-up period was 15.6 months. The estimated 3-month mortality rate was 4.7%. The overall survival (OS) rate of the entire patient group at 1 and 3 years was 80.3% and 63.6%, respectively. The 1- and 3-year graft survival rates were 78.5% and 64.4%, respectively. For ESLD, the 1- and 3-year OS rates were 82.5% and 82.5%, respectively. For HCC, the 1- and 3-year survival rates were 78.3% and 50.8%, respectively. The 1- and 3-year OS rates for the HCC patients who were beyond the Milan criteria (MC; n = 24) versus those who met the MC (n = 14) were 69.8% and 28.2% versus 92.9% and 92.9% (P = 0.0032). The 1- and 3-year disease-free survival rates for those beyond the MC versus those who met the MC were 56.8% and 39.0% versus 92.3% and 92.3% (P = 0.0089). The incidence of complications was 59.4%. Biliary complications (n = 24, 37.5%), vascular complications (n = 24, 37.5%), and infection (n = 16, 25%) were the 3 most frequent transplant-related complications. There were 10 patients with unsolved biliary complications, and a total of 5 patients died of posttransplant infections. In conclusion, patients with ESLD or HCC within the MC seeking DCD liver transplants in China obtained survival results comparable to those of other major cohorts from Western countries. However, a considerably high incidence of biliary complications, vascular complications, and infection substantially threatening the lives of patients is notable. Furthermore, the associated cost impact on medical resource utilization should not be overlooked.
Kuo
Wei-Ting
WT
Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taiwan.
Hsia
Cheng-Yuan
CY
Loong
Che-Chuan
CC
Liu
Chin-Su
CS
Tsai
Hsin-Lin
HL
Tseng
Hsiou-Shan
HS
Lee
Rheun-Chuan
RC
Tsou
Mei-Yung
MY
Wu
Chew-Wun
CW
Lui
Wing-Yiu
WY
D000328:Adult; D000368:Aged; D001660:Biliary Tract Diseases / Q000401:mortality; D002102:Cadaver; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D017093:Liver Failure / Q000401:mortality* / Q000601:surgery*; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D014019:Tissue Donors / Q000600:supply & distribution*; D014195:Travel / Q000706:statistics & numerical data*; D014652:Vascular Diseases / Q000401:mortality; D055815:Young Adult