LIVER TRANSPLANTATION-PERSPECTIVE FROM HONG-KONG

Background/Aims: We report our experience of 27 orthotopic liver trans plantations in 26 patients performed at Queen Mary Hospital, Hong Kong during the period of October 1991 to October 1995. Patients and Metho ds: There were 19 adults and 7 pediatric patients with a mean age of 2 9 years (range 8 months to 62 years). The underlying liver diseases of the 26 patients were biliary atresia (n=6), Alagille syndrome (n=1), primary biliary cirrhosis (n=2) cryptogenic cirrhosis (n=2), alcoholic cirrhosis (n=5), Wilson's disease (n=1), fulminant hepatic failure (n =3), polycystic liver (n=2), secondary biliary cirrhosis (n=1), HBV ci rrhosis (n=2) and autoimmune hepatitis with hepatocellular carcinoma ( n=1). The pathology leading to re-transplantation in a pediatric patie nt was post-transplant hepatitis of unknown etiology. The liver grafts were obtained from 19 brainstem dead and 8 living donors. The pediatr ic patient requiring re-transplantation received a left lateral segmen t graft from her mother. Two adults received left lobe grafts from the ir family members. Results: The overall graft survival is 88% and pati ent survival is 92%. There were only 2 deaths: one patient developed p rimary graft nonfunction and died from intracerebral bleeding 39 days after transplantation and the other died from graft rejection resistan t to salvage by steroid pulse and OKT3. The other patients are well wi th functioning grafts. Conclusion: We hope that the current success ra te can convince people in our locality in cadaveric organ donation so that living donors do not run the risk of dying from the operation, al though the risk is estimated to be very small.