title: First liver transplant in Qatar: an evolving program facing many challenges.
abstract: OBJECTIVE
  Beginning to do liver transplants in a developing country is challenging. We report on the first few liver transplants performed in Qatar and discuss future exceptions and challenges facing our program.
  
  
  METHODS
  The first liver transplant was performed in Qatar on December 6, 2011. Since starting the program, 4 deceased-donor liver transplants have been performed in Qatar. All recipients underwent a standard deceased-donor liver transplant procedure, which included a duct-to-duct biliary anastomosis without a veno-venous bypass. All liver transplants were performed at the Hamad Medical Corporation by a local team of surgeons without external assistance.
  
  
  RESULTS
  The 4 patients were all men, with a median age of 56 years (age range, 46-63 y). Indications for liver transplant included hepatitis C cirrhosis in 2 patients, and 1 patient with hepatitis B cirrhosis with hepatocellular carcinoma, and the other patient with cryptogenic liver cirrhosis. Median amount of blood transfused was 6 units (range, 0-10 U); median time spent in the intensive care unit was 2 days (range, 2-5 d); median amount of time spent in the hospital was 10 days (range, 9-16 d). All 4 recipients have survived after a median follow-up of 438 days (range, 33-602 d) and are enjoying a healthy life, with no significant posttransplant complications.
  
  
  CONCLUSIONS
  A deceased-donor liver transplant can be performed in Qatar with no external assistance. However, a severe organ shortage remains the biggest obstacle facing us. Efforts should be directed toward improving the number and quality of available deceased donors in Qatar. Meanwhile, live-donor liver transplant may be the only way for us, going forward, to prevent deaths on the waiting list.
authors.affiliation: Organ Transplant Center, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Hatem
authors.initials: H
authors.lastname: Khalaf
authors.forename: Moataz
authors.initials: M
authors.lastname: Derballa
authors.forename: Mohammed
authors.initials: M
authors.lastname: Elmasry
authors.forename: Ahmed
authors.initials: A
authors.lastname: Khalil
authors.forename: Rafie
authors.initials: R
authors.lastname: Yakoob
authors.forename: Muneera
authors.initials: M
authors.lastname: Almohannadi
authors.forename: Muna
authors.initials: M
authors.lastname: Almaslamani
authors.forename: Riadh
authors.initials: R
authors.lastname: Fadhil
authors.forename: Saad
authors.initials: S
authors.lastname: Al-Kaabi
authors.forename: Abdulla
authors.initials: A
authors.lastname: Al-Ansari
authors.forename: Yousuf
authors.initials: Y
authors.lastname: Almaslamani
mesh_terms: D001803:Blood Transfusion; D003906:Developing Countries; D006801:Humans; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D016730:Program Development; D015397:Program Evaluation; D011780:Qatar; D011787:Quality of Health Care; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution; D016896:Treatment Outcome; D014850:Waiting Lists