Outcome for Hong Kong residents undergoing cadaveric liver transplantation in mainland China
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1Liver Transplant Centre, Department of Surgery and Centre for the Study of Liver Disease, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam Road, Hong Kong.
Insights
Cadaveric liver transplantation in China offers an option for Hong Kong residents, but outcomes show significant post-transplant complications and mortality. Patients and clinicians must weigh these risks and resource needs before proceeding with this procedure.
Area of Science:
- Hepatology and Transplant Surgery
- Public Health and Cross-border Healthcare
Background:
- Liver transplantation is a critical treatment for end-stage liver disease.
- Cadaveric liver transplantation in mainland China has emerged as an option for patients in Hong Kong.
- Assessing outcomes is crucial for informed decision-making.
Purpose of the Study:
- To evaluate the outcomes of Hong Kong residents undergoing cadaveric liver transplantation in mainland China.
- To identify the survival rates and complication profiles associated with this procedure.
Main Methods:
- Retrospective study design.
- Review of medical records for 15 Hong Kong patients who underwent cadaveric liver transplantation in China between 1997 and 2001.
- Analysis of survival data and post-transplant complications.
Main Results:
- Overall survival rates were 80.0% at 6 months and 73.3% at 12 months.
- Four patients (27%) died, with two deaths occurring in China.
- Nine of 11 survivors (82%) experienced complications, predominantly infective (58%) and biliary (26%).
Conclusions:
- Cadaveric liver transplantation in China is a viable option for Hong Kong residents.
- Awareness of potential complications, including high rates of infective and biliary issues, is essential.
- Clinicians and patients must consider the associated risks and resource implications.
Objective:
To review the outcome for Hong Kong residents undergoing cadaveric liver transplantation in mainland China.
Design:
Retrospective study.
Setting:
Liver Transplant Centre, university teaching hospital, Hong Kong.
Subjects And Methods:
A retrospective review of medical records was undertaken for patients at Queen Mary Hospital who underwent cadaveric liver transplantation in China between 1 January 1997 and 31 December 2001.
Results:
Fifteen patients from Queen Mary Hospital underwent cadaveric liver transplantation in China during the study period. Eleven were men and four were women. Their mean age was 51 years. Disease indications included hepatitis B-related liver cirrhosis (n=7), hepatitis B-related liver cirrhosis with hepatocellular carcinoma (n=5), hepatitis C-related liver cirrhosis (n=1), hepatitis C-related liver cirrhosis with hepatocellular carcinoma (n=1), and polycystic liver and kidney disease (n=1). Nine patients were already waiting for liver transplantation at Queen Mary Hospital, and two of the nine patients were on the 'urgent' list. The overall survival rate was 80.0% at 6 months and 73.3% at 12 months. There were four (27%) deaths, two of which occurred in China. Of the 11 surviving patients, nine (82%) developed complications. Nineteen complications were seen in the 13 patients who were managed in Hong Kong following their return from China. Infective and biliary complications accounted for 58% and 26% of complications, respectively. Major complications necessitated prolonged hospitalisation for four patients and two required further laparotomy.
Conclusion:
Although cadaveric liver transplantation in China is an option for Hong Kong residents, patients and clinicians should be aware of the possible outcomes and resource implications.
