Liver transplantation for chronic liver diseases – ten years experience in Budapest

• Published in: Zeitschrift für Gastroenterologie
• Main Authors: Görög, D, Fehérvári, I, Kóbori, L, Alföldy, F, Perner, F, Járay, J
• Format: Conference Proceeding
• Language: English
• Published: 04.05.2005
• ISSN: 0044-2771; 1439-7803
• DOI: 10.1055/s-2005-869680

Aims: The liver transplant program in Budapest was started ten years ago and 216 transplantations – ten in the first year, 43 in the last year – were performed in 202 patients. Aim of the study was to evaluate our results achieved in the treatment of chronic non-malignant liver diseases that are the main indication of transplantation. Patients and methods: Data of patients grafted for chronic liver diseases were retrospectively reviewed. Beside demographic and clinical characteristics three-months mortality and morbidity including primary nonfunction, hepatic artery thrombosis, intraabdominal bleeding, biliary leakage, acute renal failure required renal replacement therapy, acute rejection, and infection with clinical signs, furthermore one year patient survival were examined in two periods: 1995–2002 and 2003–2004. Five year patient survival was calculated and compared in different groups of patients selected by indication of transplantation. Results: Of 170 patients with chronic liver disease 110 underwent liver transplantation between 1995–2002, the rest received liver graft in 2003–2004. There were 88 men and 82 women with mean age of 40 years. Distribution of patients by underlying disease was the following: cirrhosis on Hepatitis C virus (HCV, n=66), cholestatic liver disease (n=36), alcoholic liver disease (ALD, n=35) and others (n=33). The three-months mortality and morbidity were 26% and 80% in the first period and 5% and 68% in 2003–2004. The difference between mortality rates is highly significant (p<0,001). Among complications the incidence of hepatic artery thrombosis has significantly decreased (10,9% vs. 3,3%, p<0,05). The five year patient survival for cholestatic and alcoholic liver diseases were 80% and 78% respectively, and 54% in case of HCV cirrhosis. Conclusions: After learning curve the three-months mortality rate and the incidence of hepatic artery thrombosis have significantly lowered resulted in improved (91%) one year patient survival. According the late outcome cholestatic and alcoholic liver diseases were the best indication of transplantation. The significantly lower five year patient survival for HCV cirrhosis was due to the recurrence of hepatitis.