The Romanian National Program for Liver Transplantation - 852 Procedures in 815 Patients over 17 Years (2000-2017): A Continuous Evolution to Success
| Autor: | Bogdan Cotruta, Sorin Alexandrescu, Ileana Dima, Liliana Paslaru, Daniela Sasalovici, B Dorobanţu, Daniela Ungureanu, Irinel Popescu, Speranţa Iacob, Dana Tomescu, Mihnea Ionescu, Hrehoreţ D, Cristian Lupascu, Mihai Popescu, Radu Zamfir, Mariana Mihaila, Graţiela Manga, Ioana Gabriela Lupescu, Emil Matei, Mihai Toma, Gabriel Becheanu, Narcis Copca, Laura Vlad, Liana Gheorghe, Mihai Grigorie, Radu Dumitru, Mugur Grasu, Vladislav Brasoveanu, Florin Botea, Vlad Herlea, Cristian Gheorghe, Laura Popa, Gabriela Droc, Mirela Boros, Catalin Pecheanu, Ileana Constantinescu, Sanda Constantinescu, Laurenţiu Mic, Ruxandra Fota, Vasile Lungu, Corina Pietrareanu |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Cirrhosis Adolescent Waiting Lists medicine.medical_treatment macromolecular substances 030230 surgery Liver transplantation End Stage Liver Disease 03 medical and health sciences Liver disease 0302 clinical medicine Chronic liver failure otorhinolaryngologic diseases medicine Cadaver Living Donors Humans Child Continuous evolution Aged Retrospective Studies business.industry Romania Mortality rate Liver Diseases Graft Survival Liver Neoplasms Infant Retrospective cohort study Perioperative Middle Aged medicine.disease Surgery Liver Transplantation carbohydrates (lipids) stomatognathic diseases Treatment Outcome Child Preschool 030211 gastroenterology & hepatology Female Interdisciplinary Communication business Follow-Up Studies |
| Zdroj: | Chirurgia (Bucharest, Romania : 1990). 112(3) |
| ISSN: | 1221-9118 |
| Popis: | Background: Liver transplantation (LT) has become an established treatment for end-stage liver disease, with more than 20.000 procedures yearly worldwide. The aim of this study was to analyze the results of Romanian National Program of LT. Methods: Between April 2000 and April 2017, 817 pts received 852 LTs in Romania. Male/female ratio was 487/330, while adult/pediatric ratio was 753/64, with a mean age of 46 years (median 50 yrs; range 7 months - 68 yrs). Main LT indications were HBV cirrhosis (230 pts; 28.2%), HCC (173 pts; 21.2%), and HCV cirrhosis (137 pts; 16.8%). Waiting time and indications for LT, patient and donor demographics, graft features, surgical procedures, and short and long-term outcomes were analyzed. Results: DDLT was performed in 682 pts (83.9%): whole LT in 662 pts (81%), split LT in 16 pts (2.3%), reduced LT in 2 pts (0.2%), and domino LT in 1 pts (0.1%). LDLT was performed in 135 pts (16.5%): right hemiliver in 93 pts (11.4%), left lateral section in 28 pts (3.4%), left hemiliver in 8 pts (1%), left hemiliver with segment 1 in 4 pts (0.5%), and dual graft LDLT in 2 pts (0.2%). Overall major morbidity rate was 31.4% (268 pts), while perioperative mortality was 7.9% (65 pts). Retransplantation rate was 4.3% (35 pts): 27 whole LTs, 3 reduced LTs, 3 split LTs, and 2 LDLT. Long-term overall 1-, 3-, and 5-year estimated survival rates for patients were 87.9%, 81.5%, and 79.1%, respectively. One-, 3-, and 5-year overall mortality on waiting list also decreased significantly over time from 31.4%, 54.1% and 63.5%, to 4.4%, 13.9% and 23.6%, respectively. Conclusions: The Romanian National program for liver transplantation addresses all causes of acute and chronic liver failure or liver tumors in adults and children, using all surgical techniques, with good long-term outcome. The program constantly evolved over time, leading to decreased mortality rate on the waiting list. |
| Databáze: | OpenAIRE |
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