Clinical Analysis of Liver Transplantation

Kim, Dong Goo; Lee, Myung Duk; Kim, Eung Kook; Kim, Seung Nam; Kim, In Chul

Abstract

A clinical program in liver transplantation was stared at CMC in June, 1993 and since then, 24 orthotopic liver transplantations were performed (22 adult and 2 children) until July, 1998. The first 11 adult liver transplants (period I) performed from June, 1993 through June, 1997 were compared with the last 11 (period II) performed between July, 1997 and July, 1998. An analysis was made of donor and recipient characteristics, analysis of high risk group, survival data and cause of mortality, prognostic factors of donor and recipient. Mean donor age increased from 32.7 years to 37.2 years and most common cause of brain death were traffic accident and cerebrovascular accident. The highest frequency among recipient was between ages 40 and 59 and the male was predominant (21:1). The major indications for liver transplantation were liver cirrhosis due to hepatitis B or hepatitis C. High risk patients by our criteria comprised 36% of patients in period I compared with 27 % in period II. The survival rate was 45.5% in period I and a substantial improvement was observed in period II with the graft and patient survival rate of 90.9%, 100% respectively. This improved survival rate was correlated with less clinical stage, fewer high risk patient, decreased blood transfusion during operation, early recovery of respiratory and renal function in postoperative course. In conclusion, improved survival rate in period II was contributed by advanced perioperative care and more selected recipient candidate even broadening of donor organ criteria followed by early recovery of organ function.