|
Outcome for Hong Kong residents undergoing cadaveric
liver transplantation in mainland China
ACC Wong, CM Lo, CL Liu
Liver Transplant Centre, Department of Surgery and Centre for the
Study of Liver Disease, University of Hong Kong Medical Centre,
Queen Mary Hospital, Pokfulam Road, Hong Kong
OBJECTIVE. To review the outcome for Hong Kong residents
undergoing cadaveric liver transplantation in mainland China.
DESIGN. Retrospective study.
SETTING. Liver Transplant Centre, university teaching
hospital, Hong Kong.
SUBJECTS AND METHODS. A retrospective review of
medical records was undertaken for patients at Queen Mary Hospital
who underwent cadaveric liver transplantation in China between 1
January 1997 and 31 December 2001.
RESULTS. Fifteen patients from Queen Mary Hospital
underwent cadaveric liver transplantation in China during the study
period. Eleven were men and four were women. Their mean age was
51 years. Disease indications included hepatitis B–related
liver cirrhosis (n=7), hepatitis B–related liver cirrhosis
with hepatocellular
carcinoma (n=5), hepatitis C–related liver cirrhosis (n=1),
hepatitis C–related liver cirrhosis with hepatocellular carcinoma
(n=1), and polycystic liver and kidney disease (n=1). Nine patients
were already waiting for liver transplantation at Queen Mary Hospital,
and two of the nine patients were on the ‘urgent’ list.
The overall survival rate was 80.0% at 6 months and 73.3% at 12
months. There were four (27%) deaths, two of which occurred in China.
Of the 11 surviving patients, nine (82%) developed complications.
Nineteen complications were seen in the 13 patients who were managed
in Hong Kong following their return from China. Infective and biliary
complications accounted for 58% and 26% of complications, respectively.
Major complications necessitated prolonged hospitalisation for four
patients and two required further laparotomy.
CONCLUSION. Although cadaveric liver transplantation
in China is an option for Hong Kong residents, patients and clinicians
should be aware of the possible outcomes and resource implications.
Hong Kong Med J 2003;9:165-70
Key words: China; Liver transplantation; Postoperative
complications
|
