Liver transplantations in Bulgaria--initial experience

Area of Science:

• Transplantation Medicine
• Hepatology
• Surgical Innovation

Background:

• Liver transplantation (LT) is a vital treatment for liver failure.
• Advances in perioperative care, surgical techniques, and immunosuppression have improved LT outcomes.
• Establishing a new LT program requires multidisciplinary collaboration.

Purpose of the Study:

• To report the initial experience of the liver transplant team at Military Medical Academy - Sofia, Bulgaria.
• To evaluate the outcomes of early liver transplant procedures performed.
• To highlight the importance of donor and recipient selection in LT programs.

Main Methods:

• Prospective and retrospective follow-up of 37 patients undergoing 38 liver transplants (April 2007 - August 2014).
• Analysis of graft sources (cadaveric vs. live donor), MELD scores, surgical techniques (piggyback vs. classical), complication rates, and survival rates.
• Review of the multidisciplinary team and institutional requirements for LT program establishment.

Main Results:

• 38 liver transplants were performed in 37 patients, with 95% using cadaveric donors.
• The mean MELD score was 17; the 'piggyback' technique was preferred in 86% of cases.
• Overall complication rate was 48%, with an early mortality rate of 13%. 1- and 5-year survival rates were 81% and 77%, respectively.

Conclusions:

• The initial LT program at Military Medical Academy achieved favorable survival rates.
• Successful LT requires meticulous donor/recipient selection and effective teamwork.
• Living donation presents a viable option to address the shortage of cadaveric donors.