Sotiropoulos G C, Lang H, Saner F H, Beckebaum S, Wandelt M, Molmenti E P, Nadalin S, Treckmann J, Bockhorn M, Fouzas I, Malagó M, Gerken G, Broelsch C E, Paul A
Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, Essen, Germany; Department of General and Abdominal Surgery, Johannes Gutenberg University Hospital, Mainz, Germany.
Transplant Proc. 2008 Nov;40(9):3196-7. doi: 10.1016/j.transproceed.2008.08.055.
Orthotopic liver transplantation (OLT) represents the only curative treatment for end-stage liver disease, but its application is limited because of organ shortages. The purpose of this study was to review the long-term outcomes after OLT during a 2-year period of 45 rescue offers organs within Eurotransplant.
Forty-five deceased donor liver allografts had been officially offered to and rejected by other transplantation centers 162 times prior to our acceptance. Data analysis addressed recurrence of primary disease, ischemic-type biliary lesions (ITBL), re-evaluation or relisting for OLT, re-OLT, as well as overall patient and graft survivals.
Six patients underwent retransplantation because of primary nonfunction (n = 4), hepatitis C recurrence (n = 1), and secondary biliary cirrhosis following ITBL (n = 1). Five additional patients developed ITBL and received endoscopic treatment. Currently, 34 patients are alive after a median follow-up of 44.5 months. Median graft survival is 43.2 months. Patient versus patient/first graft survival at 1, 3, and 5 years is 82%, 78%, and 74%, versus 76%, 69%, and 65%, respectively.
OLT with rescue organs is a reasonable policy, with acceptable long-term patient/graft survivals, providing a real expansion of the donor pool.
