Long term liver transplant survivors
Mehmet A. Haberal1, Ebru H. Ayvazoglu Soy1, Gokhan Moray1, Figen Ozcay2, Adnan Torgay3.
1Transplantation, Baskent University, Ankara, Turkey; 2Pediatric Nephrology, Baskent University, Ankara, Turkey; 3Anaesthesia, Baskent University, Ankara, Turkey
Introduction: Few reports mentioned about long term survey. In this study, we aimed to report the outcomes of our long term LT survivors (LTS).
Materials and Methods: Our team performed the first deceased-donor LT of Turkey in 1988. Since 1988 we performed 648 deceased and living donor LT (349 adult, 299 pediatric) and 347 LT recipients are still alive with normal graft functions (54%). We evaluated the data of 174 LT recipients surviving for more than 10 years with normal graft functions.
Results: 93 recipients of 174 LTS were pediatric, the rest of 81 recipients were adult at the time of LT. 10 LTS survived for ≥20 years, 35 LTS survived for 15-19 years, 123 LTS survived for 11-14 years and 11 LTS survived for 10 years. 5patients had retransplantation due to chronic graft rejection and 4 of them are alive with normal functions, surviving for 12, 20, 28, 29 years after the first LT. We lost one of them during the early period of the second LT and it was the 19th year of his first LT. Acute rejection episodes were seen in 71 of them (40%) and seven of them were steroid resistant. We had 30 (17%) drug induced complications; 9 diabetes mellitus, 18 neurological disorder, 3 nephrotoxicity. Ten de nova malignancy were also seen and managed; 5 lymphoma, 2 squamous cell carcinoma, 1 GIST, 1 thyroid papillary carcinoma, 1 multiple myeloma. There were also HCC patients in our LTS series. 31 LTS had HCC; before LT 13 LTS were beyond Milan, 6 LTS had incidental HCC and 12 LTS were within Milan.
Conclusion: Our long term LT survivors are one of the largest series in the literature and we showed that long term survival is achieved by liver transplantation in experienced hands.
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