RESUMO
Objective: to determine the outcome of living-donor liver transplant [LDLT] donors from the first liver transplant program in Pakistan
Study Design: cohort study
Place and Duration of Study: shifa International Hospital, Islamabad, from April 2012 to August 2014
Methodology: a total of 100 live donors who underwent hepatectomy were included. Demographics, etiologies, graft characteristics and operative variables were retrospectively assessed. Outcome was assessed based on morbidity and mortality
Results: median donor age was 28 [17 - 45] years and median body mass index [BMI] was 24 kg/m[2] [15 - 36]. Male to female ratio was 1.5:1. Hepatitis B and C were the most common underlying etiologies and accounted for 79/100 [79%] of LDLT's. Overall, 93/100 [93%] donors donated a right lobe graft. Median estimated graft weight to recipient body weight [GW/BW] ratio was 1.03 [0.78 - 2]. Standard arterial anatomy was present in 56% donors. The 90-day morbidity was 13/100 [13%] and overall morbidity was 17/100 [17%]. Bile leak was encountered in 3 [3%] patients. There was no donor Mortality
Conclusion: acceptable short-term donor outcomes were achieved in an LDLT program in Pakistan with careful donor selection and planning
RESUMO
Objective: To determine the outcomes of paediatric living donor liver transplantation [LDLT] recipients from Pakistan in terms of 90-day morbidity and mortality
Study Design: Cohort study
Place and Duration of Study: Shifa International Hospital, Islamabad, Pakistan, between April 2012 and April 2015
Methodology: All patients in paediatric age group [17 years] who underwent LDLT with a minimum follow-up of 3 months, were included. All grade 2 and above complications on Clavien-Dindo system were included as morbidity. The main outcome measure was 90-day morbidity and mortality
Results: Fourteen paediatric LDLTs were performed. Median age of the recipients was 8.5 years ranging between 6 months and 17 years. Wilson's disease and cryptogenic cirrhosis were the most common etiologies [28.6% each]. Acute liver failure was present in 5 [35.7%] patients. Overall 90-day morbidity and mortality was 71.4% and 14.2%; both were attributable to pulmonary infection. No difference was observed in morbidity [21.3% vs. 42.8%, p=0.3] and mortality rates [20% vs. 11%, p=1.0] between patients with acute and chronic liver failure. Estimated 3-year survival was 85%
Conclusion: Paediatric LDLT offers a promising treatment option for acute and chronic liver failure. Mortality was attributable to post-transplant pulmonary infections