[Liver transplantation report of 23 cases]

To explore the experience of liver transplantation in patients with terminal liver failure.

From October 1991 to July 1995, 17 adults and 6 children underwent orthotopic liver transplantation. Preoperative diagnosis showed biliary atresia (n = 5), Alagille syndrome (n = 1), primary biliary cirrhosis (n = 2), cryptogenic cirrhosis (n = 2), alcoholic cirrhosis (n = 4), Wilson's disease (n = 1), fulminant hepatic failure (n = 3), polycystic liver (n = 2), secondary biliary cirrhosis (n = 1), hepatitis B cirrhosis (n = 1), and autoimmune hepatitis associated with a small hepatocellular carcinoma (n = 1). One paediatric patient suffered from hepatitis of unknown aetiology which progressed to liver failure after liver transplantation. She received retransplantation using a living graft from her mother. The liver grafts were obtained from 17 brainstem dead donors and 7 living donors.

The overall patient survival rate was 92% and graft survival rate was 88%. There were only 2 deaths, one was due to primary graft nonfunction and the other was due to persistent graft rejection not responding to pulse steroid and OKT3. The other patients are alive and well.

Liver transplantation is a feasible and viable treatment for patients with terminal liver failure in Hong Kong. The only limitation is lack of brainstem dead donor. Promotion of concept of brainstem death and organ donation in the society is the key to wide use of liver transplantation for patients with terminal liver failure in Asia.