Experience with 122 consecutive liver transplant procedures at King Faisal Specialist Hospital and Research Center

Abstract

BACKGROUNDSaudi Arabia is a leading country in the Middle East in the field of deceased-donor liver transplantation (DDLT) and living-donor liver transplantation (LDLT). We present out experience with DDLT and LDLT at King Faisal Specialist Hospital and Research Center (KFSHRC) for the period from April 2001 to January 2007.PATIENTS AND METHODSWe performed 122 LT procedures (77 DDLTs and 45 LDLTs) in 118 patients (4 retransplants) during this period of time.RESULTSThe number of adult and pediatric procedures was 107 and 11, respectively. The overall male/female ratio was 66/52 and the median age of patients was 43 years (range, 2–63 years). In the DDLT group, the median operating time was 8 hours (range, 4–19), the median blood transfusion was 6 units (range, 0–40), and the median hospital stay was 13 days (range, 6–183). In the DDLT group, after a mean follow-up period of 760 days (range, 2–2085), the overall patient and graft survival rate was 86%. In the LDLT group, the median operating time was 11 hours (range, 7–17), the median blood transfusion was 4 units (range, 0–65), and the median hospital stay was 15 days (range, 7–127). In the LDLT group, and after a mean follow-up period of 685 days (range, 26–1540), the overall patient and graft survival rates were 90% and 80%, respectively with no significant difference in patient and graft survivals between groups. Biliary complications were significantly higher in LDLT compared to DDLT (P<0.05). Vascular complications were also significantly higher in LDLT compared DDLT (P<0.05).CONCLUSIONSBoth DDLT and LDLT are being successfully performed at KFSHRC with early experience indicating a higher rate of biliary and vascular complications in the LDLT group.

Operative outcomes of adult living donor liver transplantation and deceased donor liver transplantation: A systematic review and meta-analysis

“…Finally, 19 published clinical cohort studies (4 prospective cohorts and 15 retrospective cohorts) were included in the meta-analysis. 6,7,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] The characteristics of the 19 included studies are presented in Table 1. All the studies were well designed to compare the 2 arms: LDLT and DDLT.…”

“…Significant heterogeneity among the 5 studies was found for RBC transfusion requirements (P 5 0.006, I 2 5 72%); therefore, a random-effect model was used to combine the data. Pooled results revealed that LDLT and DDLT 16 4 2 3 9 Shah et al 17 3 2 3 8 Al-Sebayel et al 18 3 2 3 8 Schmeding et al 19 3 2 3 8 Selzner et al 20 3 2 3 8 Freise et al 21 3 2 3 8 G omez et al 22 3 0 3 6 Gallegos-Orozco et al 23 3 2 3 8 Fisher et al 7 4 1 3 8 Lai et al 24 3 1 3 7 Shin et al 25 3 2 1 6 Merion et al 26 3 2 3 8 Li et al 27 3 2 3 8 Jain et al 28 3 2 3 8 Reichman et al 6 3 2 3 8 Jiang et al 29 3 2 3 8 Figure 2. Meta-analysis of controlled trials comparing DROs for LDLT and DDLT recipients on the basis of a random-effect model.…”

Management of hepatitis c genotype 4 in the liver transplant setting

“…In Saudi Arabia, where three active cadaveric liver transplant programs exist, the overall three-year graft and patient survival rates were approximately 90% and 80%, respectively, with at least 20% of the cases were due to HCV-G4. [ 24 33 34 35 36 37 ] Similarly, in Egypt, where many active living–related liver transplant programs exist and HCV-G4 represents more than 90% of cases, graft and patient survival rates were approximately 86%. [ 25 ]…”

“…In Saudi Arabia, hepatitis C represents approximately 29% of indications for liver transplantation, approximately 60% of which are secondary to HCV-G4. [ 24 ] HCV-G4 represents more than 90% of indications for liver transplantation in Egypt. [ 25 ] By contrast, HCV-G4 is a relatively uncommon indication for liver transplantation in the Western world.…”

SASLT practice guidelines: Management of hepatitis C virus infection

“…However, there is inadequate documentation of the natural history of HCV re-infection after liver transplantation in the Kingdom and worldwide. [238]…”