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Robert Król, Krystyna Jaworska, Henryk Karkoszka, Jerzy Chudek, Jacek Ziaja, Joanna Badura, Jacek Pawlicki, Grzegorz Oczkowicz, Artur Caban, Wojciech Marcinkowski, Sylwia Sekta, Jarosław Wilk, Andrzej Gabriel, Zbigniew Gonciarz, Anna Kunsdorf-Wnuk, Franciszek Kokot, Andrzej Więcek and Lech Cierpka

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.