[Liver transplant outcomes in Brno]

Area of Science:

• Hepatology
• Transplantation Surgery
• Gastroenterology

Background:

• The first liver transplant in Czechoslovakia occurred in Brno in 1983.
• The Cardiovascular and Transplantation Surgery Centre (CTSC) in Brno has significantly advanced its liver transplant program since the mid-1990s.
• Liver transplantation is a critical treatment for end-stage liver disease, with outcomes influenced by various patient and donor factors.

Purpose of the Study:

• To review the development and outcomes of liver transplantation at the CTSC in Brno.
• To analyze the indications, procedures, and survival rates of liver transplants performed.
• To identify trends in patient demographics and waiting times for liver transplantation.

Main Methods:

• Retrospective analysis of liver transplant data from the CTSC in Brno.
• Review of patient records, including indications for transplantation, graft function, and survival data.
• Statistical analysis of patient and donor characteristics, waiting times, and transplant outcomes.

Main Results:

• As of December 31, 2012, 451 liver transplants were performed, with approximately 30 performed annually.
• The primary indication for liver transplant is liver cirrhosis, with a notable increase in cases due to hepatitis C.
• One-year, five-year, and ten-year survival rates after liver transplant are 92%, 80%, and 71%, respectively. Urgent transplants constitute 11% of cases.
• Retransplants showed a 50% five-year survival rate. Primary graft dysfunction occurred in 1.5% of patients.
• Waiting times for liver transplantation are increasing, particularly for smaller recipients (<70 kg), with a median waiting time of 178 days.
• 14 combined simultaneous transplants have been performed, including liver-kidney and liver-heart-kidney procedures.

Conclusions:

• The CTSC in Brno has established a robust liver transplant program with high patient survival rates.
• Liver transplant outcomes are influenced by factors such as recipient age, donor age, and waiting time.
• Continued monitoring and research are essential to optimize liver transplant procedures and patient management.