Living Donor Liver Transplantation in South Asia: Single Center Experience on Intermediate-Term Outcomes

• Published in: World journal of surgery Vol. 42; no. 4; pp. 1111 - 1119
• Main Authors: Dar, Faisal S., Bhatti, Abu Bakar H., Qureshi, Ammal I., Khan, Nusrat Y., Eswani, Zahaan, Zia, Haseeb H., Khan, Eitzaz U., Khan, Nasir A., Rana, Atif, Shah, Najmul H., Salih, Mohammad, Nazer, Rashid
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.04.2018; Springer Nature B.V
• Subjects: Abdominal Surgery; Cardiac Surgery; Chronology; Complications; General Surgery; Liver; Liver transplantation; Liver transplants; Medicine; Medicine & Public Health; Morbidity; Mortality; Original Scientific Report; Patients; Pleural effusion; Surgery; Survival; Thoracic Surgery; Transplantation; Transplants & implants; Vascular Surgery; South Asia
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-017-4259-1

Background There is paucity of data on intermediate-term post liver transplant outcomes from South Asia. The objective of this study was to determine survival outcomes in patients who underwent living donor liver transplantation (LDLT) in a busy liver transplant center in Pakistan. Methods This study was a review of patients who underwent LDLT between 2012 and 2016. A total of 321 patients were included in this study. Early (within 90 days) and late (>90 days) morbidity and mortality was assessed. Estimated 1- and 4-year survival was determined. Results Median age was 48 (18–73) years. Male to female ratio was 4.5:1. Out of total 346 complications, 184 (57.3%) patients developed 276 (79.7%) complications in early post-transplant period, whereas there were 70 (21.3%) late complications. Most common early complication was pleural effusion in 46 (16.6%) patients. Biliary complications were the most common late complication and were seen in 31/70 (44.2%) patients. Overall 21.4% patients had a biliary complication. The 3-month mortality was 14%. The estimated 1- and 4-year OS for a MELD cutoff of 30 was 84.5 versus 72 and 80 versus 57% ( P  = 0.01). There was no donor mortality. Conclusion Acceptable intermediate-term post-transplant outcomes were achieved with LDLT. There is a need to improve outcomes in high-MELD patients.