Initial two-year results of the Oregon Liver Transplantation Program
| Autor: | Debora K. Bowers, Randall G. Lee, Michael K. Porayko, C. Wright Pinson, Clifford W. Deveney, Richard R. Lopez, Richard R. Davis, Roderick S. Johnson, Anna W. Sasaki, Emmet B. Keeffe, Joyce A. Campbell, Scott H. Goodnight, Kent G. Benner, Leslie J. Wheeler |
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| Rok vydání: | 1991 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Anastomosis Liver transplantation Oregon Postoperative Complications Induction therapy medicine Humans Recurrent hepatitis Aged Immunosuppression Therapy business.industry Antibodies Monoclonal General Medicine Hepatitis B Middle Aged medicine.disease Thrombosis Tissue Donors Surgery Liver Transplantation Transplantation Allograft rejection Female business |
| Zdroj: | American journal of surgery. 161(5) |
| ISSN: | 0002-9610 |
| Popis: | During the first 24 months of the Oregon Liver Transplantation Program, which began in October 1988, 94 patients were formally evaluated and 47 adults underwent 54 liver transplantations. Thirty-four percent of patients were veterans. The recipient operation lasted a mean of 7.4 hours (range: 4 to 16 hours). Veno-venous bypass was used routinely at first but selectively later (7 of the last 26 cases), resulting in reduced operating time. Hepatic artery reconstruction was end-to-end anastomosis in 52 cases and iliac conduit in 2. No arterial thrombosis occurred. Biliary reconstruction was choledo-chocholedochostomy in 83% and choledochojejunostomy in 17%. Biliary complications occurred in 28%. Operative mortality was 2%, and 1-year actual survival was 80%. Patients with hepatitis B fared worse, with four of six dying at a mean of 7.6 months. Overall, the median hospital stay was 30 days. Patients surviving more than 3 months had a mean Karnofsky score of 82%. No significant difference in outcome was noted in patients receiving prophylactic OKT3 monoclonal antibody (used in 45%) versus conventional immunosuppressive therapy. Overall, allograft rejection occurred in 55% of patients. Retransplantation was required in seven patients, three for primary graft nonfunction, two for uncontrolled rejection during induction therapy with OKT3, and two for graft failure secondary to recurrent hepatitis B. |
| Databáze: | OpenAIRE |
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