Results of a combined adults-children liver transplantation programme in Switzerland

Between July 1987 and August 1998, 173 orthotopic liver transplantations (O LT) were performed in Geneva. We studied a homogeneous group of 114 OLT per formed during the 6 years between 1992 and 1997 on 107 patients (89 adults and 18 children; 7 retransplantations). Although Geneva has the largest tra nsplantation programme in Switzerland and is the only centre performing pae diatric liver transplantation, the mean number of procedures per year was 1 9, corresponding to only a small transplantation programme in Europe. It co uld be reasonably questioned, therefore, whether Swiss patients are not at a disadvantage as compared with patients from European countries with large r liver transplantation centres. Although the perioperative morbidity was s till considerable, the results of this series -90% of actuarial patient sur vival at 1 and 2 years and 84% at 5 years - compare favourably with the res ults of the European Liver Transplantation Registry: 76% of actuarial patie nt survival at 1 year and 65% at 5 years. In this series, 95 patients (89%) were alive on January 1, 1998. As no patient was refused on the severity o f the liver disease and as more than 10% of OLT were performed as emergenci es, a bias due to the selection of the best cases cannot explain the good r esults. This series demonstrates that a small liver transplantation centre may obta in results that compare favourably with the results of large European centr es, and that Swiss patients are not at a disadvantage as compared with pati ents of other European countries.