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ISSN 1405-0099 (Print)

2002, Number 2

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Cir Gen 2002; 24 (2)

Liver transplantation from a cadaveric donor: Initial experience and perspectives

Holm CA, Jiménez DA, Hernández DM, Espinosa GA, Zaldívar CJ

Language: Spanish
References: 31
Page: 133-139
PDF size: 79.74 Kb.


ABSTRACT

Antecedents: The transplant program of the General Hospital National Medical Center “La Raza”, IMSS, started its activities in 1994. To the present, 500 kidney, 24 heart, and 8 liver transplants have been performed.
Objective: To describe our initial experience with orthotopic liver transplant (OLT) from multiple organ procurements in the last five years (June 1996 to June 2000) and perspectives of development.
Design: Report of cases, retrospective, longitudinal.
Setting: Third level health care hospital.
Patients and methods: Eight patients received a hepatic transplant. The following variables were assessed: Age, gender, etiology of the end-stage liver disease (ELD), ABO blood group, lymphotoxic crossed tests, associated pathology, type of procurement, perfusion, preservation, ischemia time, surgical registry, immunosuppressive therapy, graft rejection, morbidity, mortality, and patient survival.
Results: Eight patients, six women, two men, aged from 3 to 48 years. All coursed with ELD secondary to cirrhosis of diverse origin, subjected to OLT with a triple immunosuppression scheme of azathioprine, prednisone, and cyclosporine A. The eight hepatic grafts were from multiple organ donors, perfused with UW-1 solution and Custodiol™ in six and two cases, respectively. Hepatotectomy was conventional without venous shunt, conventional with veno-venous shunt, and “piggybag” in two, two and four recipients, respectively. Ischemia times, anhepatic stage, and total surgical time were within the allowed limits. Seven patients (87%) survived the procedure, four (50%) were released from the hospital and two (25%) are alive at present, over 12 months.
Conclusion: Hepatic transplantation is a therapeutic alternative for patients with progressive and incurable liver disease (pre-terminal stage, Child-B).


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