Dong-Sik Kim1, Young-Dong Yu1, Sung-Won Jung1, Kyung-Sook Yang2, Yeon-Seok Seo3, Soon-Ho Um3, Sung-Ock Suh1. 1. Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea. 2. Department of Biostatistics, Korea University College of Medicine, Seoul, Korea. 3. Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Abstract
PURPOSE: To evaluate patient triage pattern and outcomes according to types of liver transplantation as part of a new liver transplant program developed in an East Asian country with a limited number of deceased donors. METHODS: Medical records of initial 50 liver transplantations were reviewed retrospectively. RESULTS: Twenty-nine patients underwent deceased donor liver transplantation (DDLT) and 21 patients underwent living donor liver transplantation (LDLT). Mean model for end-stage liver disease scores of recipients of DDLT and LDLT were 24.9 ± 11.6 and 13.1 ± 5.4, respectively (P < 0.0001). Twenty-eight patients had HCCs and 17 of them (60.7%) underwent LDLT, which was 80.9% of LDLTs. There were 2 cases of perioperative mortality; each was from DDLT and LDLT, respectively. Median follow-up was 18 months. Overall patient and graft survival rates at 6 months, 1 and 2 years were 95.7%, 93.4%, and 89.8%, respectively. There was no significant difference in survival between DDLT and LDLT. Overall recurrence-free survival rates of hepatocellular carcinoma (HCC) patients at 6 month, 1, and 2 years were 96.3%, 96.3%, and 90.3%, respectively. There was no significant difference in recurrence-free survival between DDLT and LDLT. CONCLUSION: As a new liver transplant program with limited resource and waiting list, patients with critical condition could undergo DDLT whereas relatively stable patients with HCCs were mostly directed to LDLT. We recommend a balanced approach between DDLT and LDLT for initiating liver transplant programs.
PURPOSE: To evaluate patient triage pattern and outcomes according to types of liver transplantation as part of a new liver transplant program developed in an East Asian country with a limited number of deceased donors. METHODS: Medical records of initial 50 liver transplantations were reviewed retrospectively. RESULTS: Twenty-nine patients underwent deceased donor liver transplantation (DDLT) and 21 patients underwent living donor liver transplantation (LDLT). Mean model for end-stage liver disease scores of recipients of DDLT and LDLT were 24.9 ± 11.6 and 13.1 ± 5.4, respectively (P < 0.0001). Twenty-eight patients had HCCs and 17 of them (60.7%) underwent LDLT, which was 80.9% of LDLTs. There were 2 cases of perioperative mortality; each was from DDLT and LDLT, respectively. Median follow-up was 18 months. Overall patient and graft survival rates at 6 months, 1 and 2 years were 95.7%, 93.4%, and 89.8%, respectively. There was no significant difference in survival between DDLT and LDLT. Overall recurrence-free survival rates of hepatocellular carcinoma (HCC) patients at 6 month, 1, and 2 years were 96.3%, 96.3%, and 90.3%, respectively. There was no significant difference in recurrence-free survival between DDLT and LDLT. CONCLUSION: As a new liver transplant program with limited resource and waiting list, patients with critical condition could undergo DDLT whereas relatively stable patients with HCCs were mostly directed to LDLT. We recommend a balanced approach between DDLT and LDLT for initiating liver transplant programs.
Authors: Carl L Berg; Brenda W Gillespie; Robert M Merion; Robert S Brown; Michael M Abecassis; James F Trotter; Robert A Fisher; Chris E Freise; R Mark Ghobrial; Abraham Shaked; Jeffrey H Fair; James E Everhart Journal: Gastroenterology Date: 2007-09-14 Impact factor: 22.682
Authors: T E Starzl; C G Groth; L Brettschneider; I Penn; V A Fulginiti; J B Moon; H Blanchard; A J Martin; K A Porter Journal: Ann Surg Date: 1968-09 Impact factor: 12.969
Authors: Kim M Olthoff; Robert M Merion; Rafik M Ghobrial; Michael M Abecassis; Jeffrey H Fair; Robert A Fisher; Chris E Freise; Igal Kam; Timothy L Pruett; James E Everhart; Tempie E Hulbert-Shearon; Brenda W Gillespie; Jean C Emond Journal: Ann Surg Date: 2005-09 Impact factor: 12.969
Authors: F Y Yao; L Ferrell; N M Bass; J J Watson; P Bacchetti; A Venook; N L Ascher; J P Roberts Journal: Hepatology Date: 2001-06 Impact factor: 17.425
Authors: Sung Gyu Lee; Kwang Min Park; Shin Hwang; Ki Hun Kim; Dong Nak Choi; Sun Hyung Joo; Chul Soo Anh; Yang Won Nah; Jang Yeong Jeon; Sang Hoon Park; Kyung Suck Koh; Sang Hoon Han; Kyu Taek Choi; Kyu Sam Hwang; Yasuhiko Sugawara; Masatoshi Makuuchi; Pyung Chul Min Journal: Transplantation Date: 2002-07-15 Impact factor: 4.939
Authors: Chi Leung Liu; Sheung Tat Fan; Chung Mau Lo; William Ignace Wei; See Ching Chan; Boon Hun Yong; John Wong Journal: Ann Surg Date: 2006-03 Impact factor: 12.969
Authors: François Durand; John F Renz; Barbara Alkofer; Patrizia Burra; Pierre-Alain Clavien; Robert J Porte; Richard B Freeman; Jacques Belghiti Journal: Liver Transpl Date: 2008-12 Impact factor: 5.799