title: Liver transplantations in Bulgaria--initial experience.
abstract: The filed of liver transplantation (LT) continues to evolve and is highly effective therapy for many patients with acute and chronic liver failure resulting from a variety of causes. Improvement of perioperative care, surgical technique and immunosuppression in recent years has led to its transformation into a safe and routine procedure with steadily improving results. The aim of this paper is to present the initial experience of the transplant team at Military Medical Academy - Sofia, Bulgaria. For the period of April 2007 - August 2014 the team performed 38 liver transplants in 37 patients (one retransplantation). Patients were followed up prospectively and retrospectively. In 36 (95%) patients a graft from a cadaveric donor was used and in two cases--a right liver grafts from live donor. The mean MELD score of the transplanted patients was 17 (9-40). The preferred surgical technique was "piggyback" with preservation of inferior vena cava in 33 (86%) of the cases and classical technique in 3 (8%) patients. The overall complication rate was 48%. Early mortality rate was 13% (5 patients). The overall 1- and 5-year survival is 81% and 77% respectivelly. The setting of a new LT program is a complex process which requires the effort and effective colaboration of a wide range of speciacialists (hepatologists, surgeons, anesthesiologists, psychologists, therapists, coordinators, etc.) and institutions. The good results are function of a proper selection of the donors and the recipients. Living donation is an alternative in the shortage of cadaveric donors.
authors: N
authors: N
authors: Vladov
authors: V
authors: V
authors: Mihaylov
authors: I
authors: I
authors: Takorov
authors: I
authors: I
authors: Vasilevski
authors: T
authors: T
authors: Lukanova
authors: E
authors: E
authors: Odisseeva
authors: K
authors: K
authors: Katzarov
authors: M
authors: M
authors: Simonova
authors: D
authors: D
authors: Tomova
authors: M
authors: M
authors: Konakchieva
authors: N
authors: N
authors: Petrov
authors: N
authors: N
authors: Mladenov
authors: S
authors: S
authors: Sergeev
authors: V
authors: V
authors: Mutafchiiski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002031:Bulgaria / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D057234:Preoperative Period; D016019:Survival Analysis; D014682:Vena Cava, Inferior / Q000601:surgery; D055815:Young Adult