ORTHOTOPIC LIVER-TRANSPLANTATION (THE 1ST CLINICAL-EXPERIENCE)

The article deals with the results of work conducted according to the orthotopic liver transplantation (OLT) program from January 1990 to Ja nuary 1992. To select the patients for OLT, 54 persons (24 males and 3 0 females aged from 12 to 55 years) with diffuse (34) and focal (20) d iseases of the liver were examined. OLT was indicated for 19 patients who were registered in the waiting list. In the period of waiting for the donor organs, 5 persons died, 3 refused to undergo OLT, and 4 rema in on the waiting list. Eight OLT (including one retransplantation) we re conducted on 7 patients. The indications for OLT in these patients were: unresectable hepatocellular carcinoma (4), cirrhosis of the live r of viral etiology (1), fulgurant form of hepatitis B (1), transplant rejection crisis which could not be arrested (1). Immunosuppression w as conducted by the two- and three-component programs with the use of corticosteroids, cyclosporine A, and azathioprine. Eight crises of tra nsplant rejection were encountered, successful retransplantation of th e liver was accomplished for one of two crises which could not be arre sted. The survival of the operated on recipients ranged from 3 days to 15 months. Various complications (mainly hemorrhagic and infectious) were encountered in the posttransplantation period. At the time that t he article is written, 3 patients are living for 15, 9, and 4 months ( after retransplantation of the liver in the last case), their conditio n is satisfactory. The death of the other recipients was caused by can didosepsis (on the 40th day), polyorganic insufficiency (on the 10th a nd 3rd days), sepsis (on the 12th day). The results of the liver trans plantation program correspond to those of transplantation centers in o ther countries in the period of OLT mastering.