Clinical experience in liver transplantation from an organ transplantation center in China

Objective: To sum up the experience in liver trans-plantation in a period of ten years at a single center.Methods: We retrospectively reviewed the clinical re-cords of 120 patients receiving liver transplantationfrom April 1993 to October 2002. The patients’ cli-nical characteristics, surgical techniques, complica-tions and survival were compared in the phases of1993-1997 (phase Ⅰ), 1999 (phase Ⅱ), and 2000-2002 (phase Ⅲ).Results: Malignant liver diseases were major indica-tions for liver transplantation in phase Ⅰ(100%) andⅡ(53. 3%), but decreased markedly in percentagein phase Ⅲ(34. 0%). When compared with recipi-ents in phase Ⅰ and Ⅱ, the survival of recipients withbenign liver diseases in phase Ⅲ was significantly im-proved with the 3-month, 6-month and 1-year sur-vival rates of 85. 7%, 84. 5% and 83. 1%, respec-tively. For patients with malignant liver diseases, the3-month, 6-month and 1-year survival rates were87. 4%, 81. 1% and 46. 0%, respectively. The rein-fection rate of hepatitis B virus was 24% 12 monthsafter transplantation. With technical refinements,the incidence of postransplantation vascular compli-cations has significantly decreased from 29. 4% inphase Ⅰ and Ⅱ to 4. 9% in phase Ⅲ. Biliary compli-cations remained one of the major obstacles to long-term survival. No reno-venous bypass was applied inphase Ⅲ, providing a promising outcome.Conclusion: Strict selection of potential recipients,technical refinement, appropriate management ofvascular and biliary complications, and prophylaxisof recurrences of hepatitis B and malignant liver dis-eases are important to obtain long-term survival ofpatients receiving liver transplantation in China.