Ten-year experience with liver transplantation at Queen Mary Hospital: retrospective study

CM Lo, ST Fan, CL Liu, BH Yong, CL Lai, GKK Lau, WI Wei, PKH Tam, NS Tsoi, IOL Ng, K Young, JKF Chan, WK Tso, KY Yuen, J Wong
Liver Transplant Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong

OBJECTIVE. To report the experience with liver transplantation at the Queen Mary Hospital from 1991 to 2000.

DESIGN. Retrospective study.

SETTING. Liver transplant centre of a University teaching hospital, Hong Kong.

PATIENTS. One hundred and forty-eight patients (127 adults and 21 children) who underwent a total of 155 liver transplants using 75 cadaver grafts (full-size, 67; reduced-size, 5; split, 3) and 80 living donor grafts (left lateral segment, 15; left lobe, 6; right lobe, 59) from October 1991 to December 2000 were reviewed.

MAIN OUTCOME MEASURES. Graft and patient survival rate.

RESULTS. The most common disease indications for liver transplantation were chronic hepatitis B–related liver disease (n=74) in adults and biliary atresia (n=14) in children. Eighteen patients had hepatocellular carcinoma. Forty-eight (31%) liver transplants (three ABO-incompatible) were performed in high-urgency situations for patients requiring intensive care. The proportion of living donor liver transplants was 47.7% in adults and 73.9% in children. The overall 1-year and 5-year patient survival rates were 82% and 77%, respectively. The survival of high-risk recipients, such as those with fulminant hepatic failure (80%), chronic hepatitis B (81%), or hepatocellular carcinoma (94%), was not inferior to that of other patients.

CONCLUSION. Over the last decade, the promotion of (cadaver) organ donation through public education coupled with innovative techniques in living donor liver transplantation have enabled a liver transplantation programme to be established in Hong Kong with gratifying results.

Hong Kong Med J 2002;8:240-4

Key words: Liver transplantation; Treatment outcome