LIVER-TRANSPLANTATION

  • 1 January 1978
    • journal article
    • research article
    • Vol. 143  (3) , 73-83
Abstract
From March 1963-June 1976, 111 patients received orthotopic liver homografts. Of the recipients 42 had congenital biliary atresia. Other common diagnoses were chronic aggressive hepatitis, Laennec''s cirrhosis and primary hepatic malignancy. There were also other assorted less common diagnoses. Of the 111 patients, 31 (28%) lived at least 1 yr and 15 are still alive with follow-ups of 2 1/2-8 1/2 yr. Of the patients 7 lived for more than 5 yr; 6 of these 7 are still alive. In 1975 and 1976, clinical-pathologic correlations on all these patients were carried out. The most common causes for failure were technical misadventures including biliary tract problems, vascular thromboses and use of ischemically damaged livers. Rejection was less of a problem. Improvements in intraoperative and postoperative management were made with particular reference to biliary tract drainage and to the use of microvascular techniques. Treatment of a new series of 30 patients was begun in July 1976, and completed in Dec. 1977. After 6 to 22 mo., 15 of the 30 most recently treated patients are alive and living outside the hospital. The outlook after transplantation appears to have greatly improved and a 1 yr survival rate of 50% is projected.