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[Hepatic transplantation in cirrhosis]
P Balladur1, B de Hemptinne, A Geubel
1Service de Chirurgie Digestive, Cliniques Saint-Luc, Université Catholique de Louvain, Bruxelles.
Acta Gastro-Enterologica Belgica
|March 1, 1990
Summary
Liver transplantation outcomes were reviewed for adults with hepatic cirrhosis. Primary biliary cirrhosis and primary sclerosing cholangitis showed the best indications and satisfactory results, highlighting transplantation as a viable treatment for advanced liver disease.
Area of Science:
- Hepatology
- Transplantation Surgery
- Gastroenterology
Background:
- Hepatic cirrhosis necessitates liver transplantation in adults.
- Various etiologies of cirrhosis impact transplantation outcomes.
Purpose of the Study:
- To review indications and outcomes of liver transplantation for adult hepatic cirrhosis.
- To analyze the success rates based on cirrhosis etiology and patient factors.
Main Methods:
- Retrospective review of 107 liver transplantations in 93 adults performed up to 1989.
- Analysis of outcomes in 70 cirrhotic patients, categorized by etiology (PBC, PSC, post-necrotic, alcoholic, metabolic).
Main Results:
- Primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) demonstrated favorable indications and outcomes.
- 16 of 20 PBC patients survived with a mean follow-up of 23 months.
- Post-necrotic cirrhosis outcomes showed no significant difference based on Hepatitis B surface antigen (HBS) and delta antigen status preoperatively.
- A trend towards higher hospital mortality was observed in cirrhotic patients with preoperative pulmonary arterio-venous shunts.
Conclusions:
- Liver transplantation is indicated for specific cirrhotic etiologies like PBC with rising bilirubinemia or portal hypertension, and PSC with severe lesions.
- Transplantation outcomes are generally satisfactory for PBC.
- Pulmonary arterio-venous shunts may increase perioperative mortality risk in cirrhotic liver transplant recipients.