Evolution of Liver Transplantation in Kazakhstan: Two-Era Experience of a Single Center, the First Report.

BACKGROUND

Liver transplantation has been performed in Kazakhstan since 2011. The present study aimed to analyze the outcomes of the most experienced liver transplant center in Kazakhstan.

METHODS

Between December 2011 and December 2018, 131 liver transplantations were performed at A.N. Syzganov's National Scientific Center of Surgery. The clinical data of 88 adult patients who underwent living donor liver transplantations from December 2011 to December 2017 were analyzed. The patients were divided into 2 cohorts based on the periods in which the procedure was performed: the early era (2011-2014; n = 25) and the late era (2015-2017; n = 63). The clinical course and outcomes were retrospectively reviewed.

RESULTS

There were significant differences in the characteristics of the recipients. The patients who were treated during the late era had significantly better survival rates compared with the early era (1 year, 90.5%; 3 year, 79.6%; vs 1 year, 67.7%; 3 year 63.3%; P < .05). Right lobe grafts were used significantly more frequently during the late era (P < .05), while splenectomy was indicated significantly less frequently (P < .05). We also noted a decrease in the complication rate, including early postoperative mortality (P < .05).

CONCLUSIONS

Over the past 7 years, the liver transplant program has been established, and the operative techniques used in living donor liver transplant have changed dramatically. Patient survival has been improving with increased experience.