Liver transplantation in eastern Europe

The aim of this report is to evaluate the development of liver transplantat ion in eastern Europe until mid-1998. Representatives of gastroenterologica l and hepatological societies of the respective countries answered a questi onnaire about the most descriptive items of the issue of liver transplantat ion. The Baltic countries, together with 6 southern Balkan countries, Moldo via, and Belarus, have not developed a program of liver transplantation. In Ukraine, 7 transplantations were performed, with 3 early deaths. In Russia , 31 liver transplantations were performed, with 8 of the last 12 patients surviving short term. In Slovenia, 1 of 2 patients, and in Yugoslavia, 8 of 3 patients survived. In Croatia and Slovakia, 2 patients each died immedia tely after surgery. The number of liver transplantations is increasing in b oth Hungary and Poland. In Hungary, 63 transplantations were performed, wit h a I-year survival rate reaching 85%; in Poland, 55 adults and 29 children underwent transplantation, with an actuarial 1-year survival rate of 70%. In former East Germany, 4 centers developed their programs since 1992. A to tal of 196 transplantations were performed, with I-year survival rates vary ing from 80% to 89%. The total spectrum of indications for transplantation was standard, with a greater proportion of hepatocellular cancer compared w ith Eurotransplant statistics. In the Czech Republic, the first liver trans plantation was performed in 1983, but it was not until 1994 that the number of procedures increased steeply. Until mid-1998, a total of 182 transplant ations were performed. At the Prague Institute for Clinical and Experimenta l Medicine, we performed 94 transplantations, with a I-year patient surviva l rate of 90.6%. There has been rapid development over the last 3 years in the 3 countries of Central Europe. The progress is influenced by the sweepi ng political and economic changes.