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
Department of HPB Surgery and Liver Transplantation, Shifa International Hospital, Sector H-8/4, Pitras Bukhari Road, Islamabad, Pakistan.
Department of Anesthesiology, Shifa International Hospital, Islamabad, Pakistan.
World J Surg. 2018 Apr;42(4):1111-1119. doi: 10.1007/s00268-017-4259-1.
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.
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.
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.
Acceptable intermediate-term post-transplant outcomes were achieved with LDLT. There is a need to improve outcomes in high-MELD patients.
关于南亚地区肝移植中期结果的数据较少。本研究的目的是确定在巴基斯坦一家繁忙的肝移植中心接受活体肝移植（LDLT）患者的生存结果。
本研究回顾了2012年至2016年间接受LDLT的患者。本研究共纳入321例患者。评估早期（90天内）和晚期（>90天）的发病率和死亡率。确定估计的1年和4年生存率。
中位年龄为48（18 - 73）岁。男女比例为4.5:1。在总共346例并发症中，184例（57.3%）患者在移植后早期出现276例（79.7%）并发症，而晚期并发症有70例（21.3%）。最常见的早期并发症是胸腔积液，有46例（16.6%）患者出现。胆道并发症是最常见的晚期并发症，在31/70（44.2%）患者中可见。总体而言，21.4%的患者有胆道并发症。3个月死亡率为14%。对于MELD临界值为30的患者，估计的1年和4年总生存率分别为84.5%对72%以及80%对57%（P = 0.01）。没有供体死亡。
LDLT取得了可接受的移植中期结果。需要改善高MELD患者的结局。
