LIVER-TRANSPLANTATION IN SMALL CENTERS - PRACTICABILITY, EFFICACY ANDPERSPECTIVES

Today, orthotopic liver transplantation is the treatment of choice for the end-stage of various liver diseases, and a 1-year survival rate o f 80% and a 5-year survival rate of 70% in elective patients without t umor are reported in international surveys. The liver transplant progr amme of the Inselspital in Bern is small compared with international c entres, which may raise questions about the results and the justificat ion for such a programme. Over a period of 66 months, 62 liver transpl antations were performed in 60 patients at the Inselspital. The hospit al mortality was 3.3%, and the 2.5-year overall survival rate was 92% for elective cases without tumor. After a median follow-up of 30 month s, 68% of all patients were re-integrated in housework or full-or part -time in their profession, and 83% were independent from the help of o thers. We conclude that a small liver transplant programme based only on routine resources can achieve results comparable to the internation al standards.