title: Long-term outcome of patients undergoing liver transplantation at Rajavithi Hospital, Thailand.
abstract: OBJECTIVE
  Examine long-term outcome and survival of patients with liver transplantation at Rajavithi Hospital, a small-volume transplant center in Bangkok, Thailand.
  
  
  METHODS
  Between May 1996 and December 2010, 21 liver transplantations were performed Piggyback technique and portal vein flushing with one liter of cold normal saline was used to prevent reperfusion injury. Color Doppler ultrasound was performed routinely. Data collection included demographic data, complications, operation time, ischemic time, duration of stay in intensive care unit (ICU), hospitalization period, and survival.
  
  
  RESULTS
  There were two cases withdrawn from immunosuppressant drugs due to loss of follow-up and recidivism. Late death in three patients was from bleeding after hemiarthroplasty, chronic rejection, and lymphoma. Overall, 5-year and 10-year survival were 62% and 42% respectively Biliary complication rate was 9.5%. Two cases were under early reoperation due to bleeding from hepatic artery and retrohepatic vein. Hepatic vein occlusion was found in one case that had underlying Budd Chiari. One case with hepatocellular carcinoma, 10 nodules in both lobes of liver had survived more than three years after transplantation.
  
  
  CONCLUSIONS
  Liver transplantation is a high-cost procedure. Good long-term results depend on expensive drugs, skilled surgeons, state-of-the-art equipment, and good team work. Policy and support from the government play an important role for successful transplantation, especially in developing countries.
authors.affiliation: Department of Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand. somboonsub@hotmail.com
authors.forename: Somboon
authors.initials: S
authors.lastname: Subwongcharoen
authors.forename: Sa-ard
authors.initials: SA
authors.lastname: Treepongkaruna
authors.forename: Kawin
authors.initials: K
authors.lastname: Leelawat
authors.forename: Kanchana
authors.initials: K
authors.lastname: Ruksakul
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008107:Liver Diseases / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D013785:Thailand; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents