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Related Experiment Videos

Liver transplantation. Experience with 100 cases.

J L Szpakowski1, K Cox, P Nakazato

  • 1Transplant Institute, California Pacific Medical Center, San Francisco.

The Western Journal of Medicine
|November 1, 1991
PubMed
Summary
This summary is machine-generated.

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This study on 100 liver transplants found that a low-dose corticosteroid regimen improved outcomes, reducing surgical complications and infections while maintaining high patient survival rates.

Area of Science:

  • Hepatology
  • Transplant Surgery
  • Immunosuppression

Background:

  • Liver transplantation is a complex procedure with significant risks of rejection and infection.
  • Optimizing immunosuppressive regimens is crucial for improving patient and graft survival.
  • Pediatric liver transplantation presents unique challenges, including size matching and reduced organ availability.

Purpose of the Study:

  • To evaluate the outcomes of 100 liver transplants performed between March 1988 and November 1989.
  • To assess the efficacy of a specific immunosuppressive protocol involving Minnesota antilymphocyte globulin, cyclosporine, and low-dose corticosteroids.
  • To compare the incidence of surgical complications and infections with other published liver transplant series.

Main Methods:

  • A retrospective analysis of 100 liver transplants in 90 patients.

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  • Immunosuppression: prophylactic Minnesota antilymphocyte globulin, cyclosporine, and low-dose corticosteroids.
  • Rejection treatment: OKT3 (monoclonal antibody) or corticosteroids.
  • Special consideration for pediatric recipients, including size reduction of donor livers.

    • Main Results:

    • Overall 2-year patient survival was 85%.
    • 80% of patients experienced at least one episode of rejection.
    • Serious infections occurred in 34% of adults and 25% of children.
    • Hepatic artery thrombosis occurred in 2%, and biliary complications in 12% necessitating reoperation.
    • Reduced incidence of surgical complications and lower rates of fungal/viral infections compared to other series.

    Conclusions:

    • A low-dose corticosteroid regimen during convalescence may reduce surgical complications and infections without compromising patient or graft survival.
    • This immunosuppressive strategy appears to offer advantages over previously reported protocols.
    • Liver transplantation outcomes, particularly in pediatric patients, can be improved through careful management and optimized immunosuppression.