Deceased-Donor Liver Transplantation: 10 Years' Experience at Change Gung Memorial Hospital-Kaohsiung Medical Center

摘要

Background: The purpose of this study was to summarize the outcomes we achieved using deceased-donor liver transplantation (DDLT) in the past 10 years at Chang Gung Memorial Hospital-Kaohsiung Medical Center (CGMH-KMC). Methods: Between March 1993 and March 2003, 53 DDLTs were performed at CGMH-KMC. Patients were divided into 2 stages: stage 1 (n = 22) from March 1993 to February 1998, and stage 2 (n = 31) from March 1998 to March 2003. Indications for transplantation, patient demographics, surgical procedures, and long-term outcomes were reviewed. Results: Indications for transplantation were biliary atresia (16), post-hepatitis B/C viral cirrhosis with or without hepatocellular carcinoma (21), Wilson's disease (8), primary biliary cirrhosis (3), and miscellaneous (5). Two retrans-plants were carried out for secondary biliary cirrhosis using primary live-donor liver transplantation (LDLT). Ten patients received grafts from 6 split-liver transplantations. Over-all Kaplan-Meier 1-, 3-, and 5-year survival rates were 88.46%, 83.86%, and 79.87%, respectively. A significant improvement in patient survival was observed in stage 2. The Kaplan-Meier 1- and 5-year patient survival rates in stage 2 were 96.67% and 92.95%, respectively. Fifteen patients developed vascular complications. Nine patients died in this series for an overall mortality rate of 17%. Conclusions: Deceased-donor liver transplantation is well established as the treatment of choice for acute and chronic liver failure in Taiwan. Satisfactory outcomes have been attained in those transplanted to date.