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Abstract

Objectives: We present here the outcomes of our first 500 liver transplants and discuss the lessons learned during this time. The main cause of chronic liver failure was biliary atresia in pediatric patients (30.4%) and chronic hepatitis B infection in adults (35.6%). The complication rate for primary nonfunction was 3.8%, overall biliary complications 24.0% (significantly higher after adult living-donor liver transplant, 30.3%), hepatic artery thrombosis 1.6%, portal vein thrombosis 3.0%, retransplant 3.8%, acute cellular rejection 29.6%, and bacterial infection 39.4%. Overall 1-, 3-, and 5-year patient survival rates in the first 500 consecutive transplants performed on recipients within United Network for Organ Sharing listing criteria were 87.8%, 85.0%, and 78.6%; for hepatocellular carcinoma patients beyond the Milan criteria, survival rates were 71.9%, 52.5%, and 38.2%. Conclusions:In regions without a sufficient number of deceased donors, living-donor liver transplant, with its associated problems, is the only alternative to deceased-donor liver transplant. Liver transplant requires teamwork, with all players working well together for a successful outcome. The important keys to success in liver transplant include decision-making, timing, surgical skills, experience, and close follow-up.

Pediatric liver transplantation outcomes from a single center in Thailand

“…Regarding other patient characteristics, the median age of patients [1.2 (0.8-3.8) years] in the current study is relatively lower compared with other studies. Moreover, the median PELD and MELD scores were 20 (13-26.8) and 19.5 (15.8-26.3), respectively, which is comparable to other studies[ 8 , 9 ].…”

“…Kasahara et al [ 7 ] reported on 414 and 22 Living- and deceased-donor transplantations up to 2016 from the Organ Transplantation Center at the National Center for Child Health and Development in Japan. In Turkey, Yankol et al [ 8 ] reported on 135 cases of pediatric LT, 91.4% of which involved living donors. However, the rate of living-donor LT in the current study was higher than in Western and Middle Eastern countries, including centers in the United States (6%)[ 9 ] and Iran (40.6%)[ 10 ].…”