RENAL-TRANSPLANT IN GENEVA, OR 32 CONSECU TIVE TRANSPLANTS WITHOUT MORTALITY IN 2 YEARS

Between 1 january 1992 and 31 december 1993, 32 Liver transplantations were performed in 29 patients (5 transplants in 3 children and 27 tra nsplants in 26 adults) at Geneva University Hospital. Despite 5 super- urgent transplantations (3 fulminant hepatitis, 1 end-stage Wilson dis ease and 1 primary nonfunction), all patients are still alive and all have lived more than 10 months. On 1 october 1994, all patients were a t home and 93% were in good general condition. No patient of this seri es had been transplanted for cancer and all patients positive for hepa titis B surface antigen receive long-term administration of anti-HBs i mmune globulin: in this respect, the long-term mortality risk of the p resent series of patients seems to be very low. Although these results highlight that liver transplantation can be performed safely by a com petent medico-surgical team, two significant difficulties have to be o utlined. First, patients are likely to die on the waiting list due to unavailable grafts, especially in emergency cases. Second, the postope rative period of patients with decompensated end-stage liver disease a t the time of liver transplantation is still one of high morbidity. Th ese facts underline that chronic liver disease patient should be evalu ated for liver transplantation prior to the terminal decompensated sta ge of the disease, when the candidate's invariably poor general condit ion precludes successful liver transplantation.