Faraj Walid, Deborah Mukherji Deborah, Fakih Hawraa, Majzoub Nadim, Khalife Mohamed
Department of Surgery, American University of Beirut Medical Center, Lebanon.
Ann Transplant. 2010 Jul-Sep;15(3):25-9.
The aim of this study is to review all liver transplants performed at the American University of Beirut Medical Center from 1998 to present.
MATERIAL/METHODS: From 1998 to present, 15 liver transplants were performed in our institution. Of these, 10 were adults and 5 children. Indications for adult transplants were: 2 alcoholic liver cirrhosis, 2 cryptogenic, hepatitis B, hepatitis C with HCC, 1 subacute liver failure, 1 Budd Chiari syndrome, 1 biliary cirrhosis secondary to iatrogenic common bile duct injury, and 1 multiple hydatid disease of the liver. Pediatric transplant indications were: 2 cryptogenic liver cirrhosis, 1 extrahepatic biliary atresia, 1 familial hypercholesterolemia, and 1 congenital hepatic fibrosis. Of the 14 transplants, 4 were living related liver transplants.
Patient survival was 67% at 1, 5 and 10 years. There were 5 deaths at a median of 9 days (range 1-56) post-transplantation. The causes of death were: 2 primary non-functions, 1 intraoperative cardiac arrest, 1 portal and hepatic artery thrombosis, and 1 severe cellular rejection. There were 2 biliary complications and 2 major vascular complications. All 9 survivors are well, with normal liver function tests at a median follow-up time of 70 months (range 13-131) after transplantation.
Although our numbers are small, the 10-year survival rate is acceptable compared to other series. Cadaveric organ donations and transplantations should be encouraged so that more transplants can be performed. Living related liver transplant is an important alternative source of organs, but should not replace cadaveric donation.
本研究的目的是回顾1998年至今在美国贝鲁特美国大学医学中心进行的所有肝移植手术。
材料/方法：1998年至今，我们机构共进行了15例肝移植手术。其中，10例为成人，5例为儿童。成人肝移植的适应证为：2例酒精性肝硬化、2例隐源性肝硬化、乙肝、丙肝合并肝癌、1例亚急性肝衰竭、1例布加综合征、1例医源性胆总管损伤继发的胆汁性肝硬化以及1例肝多发包虫病。儿童肝移植的适应证为：2例隐源性肝硬化、1例肝外胆管闭锁、1例家族性高胆固醇血症以及1例先天性肝纤维化。在这14例移植手术中，4例为活体亲属肝移植。
1年、5年和10年的患者生存率为67%。移植后中位时间9天（范围1 - 56天）有5例死亡。死亡原因分别为：2例原发性无功能、1例术中心脏骤停、1例门静脉和肝动脉血栓形成以及1例严重细胞排斥反应。有2例胆道并发症和2例主要血管并发症。所有9例存活者情况良好，移植后中位随访时间70个月（范围13 - 131个月）时肝功能检查正常。
尽管我们的病例数较少，但与其他系列相比，10年生存率是可以接受的。应鼓励尸体器官捐献和移植，以便能进行更多的移植手术。活体亲属肝移植是重要的器官替代来源，但不应取代尸体捐献。
