Introduction of Liver Transplant Programme in Upper Silesia

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Introduction of Liver Transplant Programme in Upper Silesia

Liver transplantation is the only method of treatment of patients with end stage liver insufficiency. Inadequate number of transplantations in Poland in relation to demands causes a need of new liver transplantation centres formation.

The aim of the study was to present process of introduction of liver transplantation programme and results of the first 12 transplantations.

Material and methods. Preparations to transplantation were based on training of surgical, anaesthetics and nephrological teams in transplant centres in Paris, Birmingham and Warsaw. Own protocols of organ harvesting, recipients' qualification, transplantation and postoperative treatment were worked out; they were a result of experience acquired in teaching centres. From October 16, 2005 to October 2006, 12 liver transplantations were performed in patients with end stage liver insufficiency of different origin. Patients' age varied from 21 to 67 years. The stage of liver failure according to Child-Pough was 8.6±2.8, and MELD 18.6±7.2. All elective operations were performed using Piggyback technique. Immunosuppression regimen was uniform and consisted of tacrolimus and prednisolone.

Results. One patient died due to post reperfusion syndrome with no respond to catecholamine treatment. In 1 patient developed primary lack of the liver graft function that required re-transplantation, which was successfully performed on 2nd postoperative day. Among 10 patients who were discharged from the hospital on mean 31 postoperative day all are alive, and 7 of them returned to full live activity.

Conclusion. Training in famous liver transplant centres and own experience in kidney and pancreas transplantation allowed for successful introduction of liver transplantation programme.

Merion RM, Schaubel DE, Sima CS, et al.: Reevaluation of the survival benefit of liver transplant by MELD. W: Abstracts for the 2006 Joint International Congress of ILTS, ELTA and LICAGE, May 3-6, 2006, Milan, Italy, Liver Transplant 2006; 12: C18.

Kim WR, Therneau TM, Benson JT, et al.: Deaths on the liver transplant waiting list: an analysis of competing risks. Hepatology 2006; 43: 345-51.

Buenadicha AL, Martin LG, Martin EE, et al.: Assessment of short-term survival after liver transplant by the Model for End-Stage Liver Disease. Transplant Proc 2005; 37: 3881-83.

Silberhumer GR, Hetz H, Rasoul-Rockenschaub S, et al.: Is MELD score sufficient to predict not only death on waiting list, but also post-transplant survival? Transpl Int 2006; 19: 275-81.

Habib S, Berk B, Chang CC, et al.: MELD and prediction of post-liver transplantation survival. Liver Transpl 2006; 12: 440-47.

Boin IF, Leonardi MI, Pinto AO, et al.: Liver transplant recipients mortality on the waiting list: long-term comparison to Child-Pugh classification and MELD. Transplant Proc 2004; 36: 920-22.

Guo DM, Bian J: Multislice spiral CT angiography in evaluation of liver transplantation candidates. Hepatobiliary Pancreat Dis Int 2005; 4: 32-36.

Cherqui D, Lauzet JY, Rotman N, et al.: Orthotopic liver transplantation with preservation of the caval and portal flows. Technique and results in 62 cases., Transplantation 1994; 58: 793-96.

Scatton O, Meunier B, Cherqui D, et al.: Randomized trial of choledochocholedocho-stomy with or without a T tube in orthotopic liver transplantation. Ann Surg 2001; 233: 432-37.

Alsharabi A, Zieniewicz K, Patkowski W, et al.: Assessment of early biliary complications after orthotopic liver transplantation and their relationship to the technique of biliary reconstruction. Transplant Proc 2006; 38: 244-46.

Wójcicki M, Lubikowski J, Zeair S, et al.: Biliary complications following adult liver transplantation with routine use of external biliary drainage. Ann Transplant. 2005; 10: 21-25.

Bacchella T, Figueira ER, Makdissi FF, et al.: Biliary reconstruction without T-tube in liver transplantation. Transplant Proc 2004; 36: 951-52.

Hwang S, Lee SG, Sung KB, et al.: Long-term incidence, risk factors, and management of biliary complications after adult living donor liver transplantation. Liver Transpl 2006; 12: 831-38.

Hellinger A, Roll C, Stracke A, et al.: Impact of colour Doppler sonography on detection of thrombosis of the hepatic artery and the portal vein after liver transplantation. Langenbecks Arch Chir 1996; 381: 182-85.

Huang DZ, Le GR, Zhang QP, et al.: The value of color Doppler ultrasonography in monitoring normal orthotopic liver transplantation and postoperative complications. Hepatobiliary Pancreat Dis Int 2003; 2: 54-58.

Schaeff B, Paolucci V, Encke A: Color doppler ultrasound in intensive care monitoring after liver transplantation. Zentralbl Chir 1994; 119: 99-103.

Kok T, Slooff MJ, Thijn CJ, et al.: Routine Doppler ultrasound for the detection of clinically unsuspected vascular complications in the early postoperative phase after orthotopic liver transplantation. Transpl Int 1998; 11: 272-76.

Maceneaney PM, Malone DE, Skehan SJ, et al.: The role of hepatic arterial Doppler ultrasound after liver transplantation: an «audit cycle» evaluation. Clin Radiol 2000; 55: 517-24.

Massicotte L, Sassine MP, Lenis S, et al.: Survival rate changes with transfusion of blood products during liver transplantation. Can J Anaesth 2005; 52: 148-55.

Massicotte L, Sassine MP, Lenis S, et al.: Transfusion predictors in liver transplant. Anesth Analg 2004; 98: 1245-51.

Ramos E, Dalmau A, Sabate A, et al.: Intraoperative red blood cell transfusion in liver transplantation: influence on patient outcome, prediction of requirements, and measures to reduce them. Liver Transpl 2003; 9: 1320-27.

Massicotte L, Lenis S, Thibeault L, et al.: Effect of low central venous pressure and phlebotomy on blood product transfusion requirements during liver transplantations. Liver Transpl 2006; 12: 117-23.

Polish Journal of Surgery

The Journal of Foundation of the Polish Journal of Surgery

Journal Information

CiteScore 2016: 0.29

SCImago Journal Rank (SJR) 2016: 0.166
Source Normalized Impact per Paper (SNIP) 2016: 0.207


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