Update on liver transplantation: a single center experience from 1998 to present

Abstract

Background: Liver transplantation is the treatment of choice for patients with liver cirrhosis. The aim of this study is to review all liver transplants performed at the American University of Beirut Medical Center from 1998 to present. Methods: 24 liver transplants were performed at AUBMC. Of these, 17 were adults and 7 were children. Indications for adult transplants : 2 alcoholic liver cirrhosis, 2 hepatitis B, hepatitis C with HCC, 1 sub-acute liver failure, 1 budd-chiari syndrome, 1 biliary cirrhosis secondary to iatrogenic common bile duct injury, 1 multiple hydatid disease of the liver, 5 autoimmune hepatitis, and 1 vanishing bile duct syndrome. Pediatric transplant indications: 3 cryptogenic liver cirrhosis, 1 extrahepatic biliary atresia, 1 familial hypercholesterolemia, 1 familial intrahepatic cholestasis, and 1 congenital hepatic fibrosis. Of the 23 transplants, 7 were living related. Results: Patient survival was 74% at 1, 5 and 10 years. There were 6 deaths at a median of 9 days (range 1-56) post-transplantation. The causes of death: 2 primary non-functions, 2 intraoperative cardiac arrest, 1 portal and hepatic artery thrombosis, and 1 severe cellular rejection. All 18 survivors are well, with normal liver function tests at a median follow-up time of 93 months (range 10-185) post-op. Conclusion: Cadaveric organ donations should be encouraged to increase the number of transplants. Living related liver transplant is an important alternative source of organs, but shouldn’t replace cadaveric donation.