Liver Transplantation: An Experience in Post-Operative Follow Up Of 80 Patients

Background: Orthotopic liver transplantation (OLT) is regarded as the only choice for treatment of patients with end stage liver disease (ESLD) and liver failure. Outcome for those patients is much better after liver transplantation resulting in reasonably good quality of life, provided complications are detected and treated promptly. Evaluation of needle liver graft biopsies and extensive clinicopathological correlation play an important role in the determination of liver allograft dysfunction after transplantation. Objective: To evaluate possible post-transplant outcome of patients underwent OLT. Methods: We analyzed 80 patients with liver cirrhosis who underwent deceased donor liver transplantation (DDLT) over a 10-year period in a cohort and observational study. The study was performed from June 2000 to June 2010 and included 75 men and 5 women. Results: Among all patients; origin of cirrhosis was post-viral in 76 patients, brimary biliary cirrhosis (PBC) in 2 cases, autoimmune hepatitis (AIH) in one case and cryptogenic cirrhosis in another case. The cases of post-viral cirrhosis were all of viral C etiology with 20 cases associated with hepatocellular carcinoma and 2 associated with hepatitis B viral infection. The patients are followed up for at least 18 months after enrolling in the study. They all had routine tests at the start of the study used as baseline for each patient. These tests are repeated according to the requirements of the individual patient. All patients had Tacrolimus (FK 506) as an immunosuppressive agent. Patients with hepatitis B viral infection had hepatitis B immunoglobulin, along with Lamivudine for relapse prophylaxis. Out of 80 patients, postoperative liver biopsy was performed, at least once, for 73 patients. The results of the biopsies revealed that recurrent HCV was detected in 46 (63.01%) cases, acute rejection in 14 (19.18%) cases, chronic rejection in 4 (5.48%) cases, cirrhosis in 2 (2.74%) cases, fibrosing cholestatic hepatitis in 2 (2.74%) cases, chronic active hepatitis with cholangitis and bile duct obstruction in 2 (2.74%) cases, recurrent primary biliary cirrhosis in 2 (2.74%) cases and one case (1.37%) with acquired schistosoma japonicum. A total of 24 (30%) patients died during follow up. Conclusion: The results of liver graft biopsies revealed that recurrent HCV is the prominent cause of organ dysfunction. Meanwhile; organ rejection was less frequently encountered. The complications of liver transplantation can be controlled and managed if diagnosed promptly and treated early. [Zeinab Kamar, Medhat El-Sahhar, Hala Agena, Nehal A. Radwan and Charles Nelson. Liver Transplantation: An Experience in Post-Operative Follow Up Of 80 Patients. Life Science Journal 2011;8(4):1088-1096]. (ISSN: 1097-8135). http://www.lifesciencesite.com. 135