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Liver transplantation: the Italian experience
S Fagiuoli1, V G Mirante, M Pompili
1Surgical and Gastroenterological Sciences Department, University Hospital of Padua, Italy. fagiuoli@unipd.it
Summary
Liver transplantation offers good long-term survival for end-stage liver disease patients. Careful selection ensures excellent outcomes even for complex cases like alcoholic cirrhosis and hepatitis B virus-related cirrhosis.
Area of Science:
- Hepatology
- Transplant Surgery
- Gastroenterology
Background:
- Liver transplantation is a critical treatment for end-stage liver disease unresponsive to medical management.
- This study focuses on the long-term outcomes of liver transplantation in Italy.
Purpose of the Study:
- To analyze the long-term experience and outcomes of liver transplantation across multiple Italian centers.
- To evaluate survival rates and identify factors influencing graft success and failure.
Main Methods:
- Retrospective data collection from 15 Italian liver transplant centers.
- Analysis of 3323 liver transplants performed on 3026 patients.
- Centralized data filing for comprehensive review.
Main Results:
- Cumulative survival reached 72.4%, with 3-, 5-, and 10-year survival rates of 72.3%, 68.8%, and 61.3%, respectively.
- Hepatitis B and C virus-related cirrhosis were the most common indications (59.4%).
- Excellent survival was noted for alcoholic cirrhosis, hepatitis B virus-related cirrhosis, and hepatocellular carcinoma. Graft failure was primarily due to primary non-function (28.7%) and disease recurrence (25.4%). Infections and sepsis were the leading causes of post-transplant death (42%).
Conclusions:
- Liver transplantation provides excellent survival rates, particularly for carefully selected patients with indications such as alcoholic cirrhosis, hepatitis B virus-related cirrhosis, and hepatocellular carcinoma.
- The study highlights the importance of patient selection for optimizing outcomes in liver transplantation.