title: Liver Transplant Outcomes in a Newly Started Program.
abstract: OBJECTIVE
  Kazakhstan is experiencing a high demand for liver transplants. More than 1000 patients have end-stage liver disease in the country, and liver transplant is the only viable option for their treatment.
  
  
  METHODS
  Liver transplant patients, treated from February 2013 to December 2014, were included in this retrospective analysis.
  
  
  RESULTS
  From February 2013 to December 2014, seven patients received a liver transplant in our center (1 pediatric patient was excluded). Deceased liver recipients' (n = 3) median age was 52 years and median Model for End-Stage Liver Disease score 9. The indication for transplant was uncontrolled portal hypertension due to autoimmune liver disease. Cadaveric donors' median age was 45 years. Recipients' intensive care unit stay was > 5 days, time on inotropic support was > 3 days. Mean cold ischemic time was > 6 hours, and secondary ischemic time was 67 minutes. One patient in the deceased donor transplant group died during postoperative week 1 from hepatic artery thrombosis. Living donor liver recipients' (n = 3) median age was 47 years (43-48 y) and median Model for End-Stage Liver Disease score was 17 (range 14-20). Liver disease was hepatitis virus related (hepatitis C virus in 1 patient and hepatitis B and D virus in 2 patients). Mean cold ischemic time was 0.43 hours, and mean secondary ischemic time was 64 minutes. One recipient in the living donor liver group died early in the postoperative period from hemorrhage.
  
  
  CONCLUSIONS
  Our experience was insufficient to adequately assess morbidity and survival rates in patients for whom the longest follow-up was 25 months. However, no episodes of rejection were observed. Survival rates between living and deceased donor recipients were equivalent, although cadaveric-donor liver conditions were imperfect. This analysis demonstrates the necessity for timely diagnosis of surgical complications, which accounted for all mortality incidence in our series.
authors.affiliation: From the JSC National Scientific Center for Oncology and Transplantology, Astana, Kazakhstan.
authors.forename: Tokan
authors.initials: T
authors.lastname: Sultanaliev
authors.forename: Assan
authors.initials: A
authors.lastname: Zhexembayev
authors.forename: Adilbek
authors.initials: A
authors.lastname: Mukazhanov
authors.forename: Bakhyt
authors.initials: B
authors.lastname: Zharkymbekov
authors.forename: Gani
authors.initials: G
authors.lastname: Kuttymuratov
authors.forename: Zhanat
authors.initials: Z
authors.lastname: Spatayev
authors.forename: Bauyrzhan
authors.initials: B
authors.lastname: Ibrayev
authors.forename: Kakharman
authors.initials: K
authors.lastname: Yesmembetov
authors.forename: Aiymkul
authors.initials: A
authors.lastname: Ashimkhanova
authors.forename: Mels
authors.initials: M
authors.lastname: Asykbayev
mesh_terms: D000293:Adolescent; D000328:Adult; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007623:Kazakhstan; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D017064:Process Assessment, Health Care; D015397:Program Evaluation; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult