[Orthotopic liver transplantation (first clinical experience)]

Area of Science:

• Hepatology
• Transplant Surgery
• Immunology

Background:

• Orthotopic liver transplantation (OLT) is a complex procedure for end-stage liver disease.
• Early OLT programs faced significant challenges in patient selection, organ availability, and post-operative management.

Purpose of the Study:

• To evaluate the initial results of an orthotopic liver transplantation program.
• To analyze patient selection criteria, indications for OLT, and early outcomes.
• To identify complications and survival rates during the program's early phase.

Main Methods:

• Retrospective analysis of patients evaluated for OLT between January 1990 and January 1992.
• Review of 54 patients assessed for OLT, with 19 listed and 8 procedures performed.
• Analysis of immunosuppression protocols, transplant rejection episodes, and post-operative complications.

Main Results:

• Eight OLTs (including one retransplantation) were performed on 7 patients for indications including hepatocellular carcinoma, viral cirrhosis, hepatitis B, and rejection.
• Transplant rejection occurred in 8 instances, with one successful retransplantation.
• Survival ranged from 3 days to 15 months, with 3 patients alive at the time of writing; complications included hemorrhagic and infectious issues.

Conclusions:

• The early outcomes of this OLT program reflect the learning curve and challenges typical of centers mastering the procedure during that era.
• Despite complications and mortality, the program demonstrated feasibility and achieved long-term survival in some recipients.
• Continuous improvement in patient selection, surgical technique, and immunosuppression management is crucial for successful OLT programs.