Surgery, Gastroenterology and Oncology
Vol. 26, Nr. 1, Mar 2021
A Combined Program of Cadaveric and Living-Related Liver Transplantation in a Single Center: An Experience of 1,000 Operations
Florin Botea, Bogdan Dorobantu, Sorin Alexandrescu, Mihai Grigorie, Emil Matei, Radu Zamfir, Vasile Lungu, Dragos Zamfirescu, Dana Tomescu, Gabriela Droc, Daniela Ungureanu, Ruxandra Fota, Gratiela Manga, Mihai Popescu, Liana Gheorghe, Speranta Iacob, Corina Pietrareanu, Mariana Mihaila, Laurentiu Micu, Cristian Gheorghe, Bogdan Cotruta, Sanda Constantinescu, Ioana Lupescu, Mugur Grasu, Mirela Boros, Radu Dumitru, Mihai Toma, Liliana Paslaru, Laura Vlad, Ileana Constantinescu, Ileana Dima, Vlad Herlea, Gabriel Becheanu, Catalin Pecheanu, Daniela Sasalovici, Doina Hrehoret, Vladislav Brasoveanu, Mihnea Ionescu, Irinel Popescu
Article DOI: 10.21614/sgo-26-328
Background: The liver transplantation program of Fundeni Clinical Institute reached a milestone (1000 operations performed by the same team in 20 years). It is a program for both adults and children, including cadaveric and living donor liver transplantations. We analyze the indications and results to emphasize the advantages of a combined program.

Methods: Between April 2000 and March 2020, 957 patients received 1,000 LTs at a single institution (Fundeni Clinical Institute, Bucharest, Romania). The demographics of donors and recipients, indications for liver transplantations, surgical procedures and results were analyzed.

Results: Deceased donor liver transplantation (DDLT): 831 DDLTs in 790 patients (83.1%): whole LT in 769 patients (80.4%), split LT in 17 patients (2%), reduced-size LT in 2 patients (0.5%), auxiliary LT in 1 patient (0.1%) and domino LT in 1 patient (0.1%). Living donor liver transplantation (LDLT): 169 LDLTs in 167 patients (17.2%) using right hemiliver in 121 patients (12.6%), left lateral section in 28 patients (2.9%), left hemiliver in 9 patients (0.9%), left hemiliver with segment 1 in 6 patients (0.6%), and dual graft LDLT in 3 patients (0.3%). Overall major morbidity rate was 42.2% (422 patients), while perioperative mortality was 8.3% (79 patients). Retransplantation rate was 4.5% (43 patients). The estimated 1-, 3-, 5- and 10-year overall survival rates for LT patients were 82.3%, 77.8%, 76.3% and 71.2%, respectively.

Conclusions: A combined cadaveric and living donor LT program including all surgical variant LT procedures offers the possibility to increase the volume with the well-known consequences on the postoperative results. The living donor program has a positive influence on the waiting list mortality; using both cadaveric and living donors enhance the possibilities in the case of an urgent retransplantation.

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Surgery, Gastroenterology and Oncology is indexed in Scopus, CrossRef (DOI: 10.21614/sgo)

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