Uncommon indications for orthotopic liver transplantation
Halima Gottfriedová Orcid.org 1, Pavel Trunečka2, Lucie Janečková Orcid.org 3, Věra Lánská Orcid.org 4, Julius Špičák Orcid.org 1
1 Klinika hepatogastroenterologie, Transplantcentrum, IKEM, Praha
2 Transplantcentrum, IKEM, Praha
3 Klinika anesteziologie, resuscitace a intenzivní péče, IKEM, Praha
4 Lékařská statistika, IKEM, Praha
As of 13th August 2013,1,000 liver transplants have been carried out at the Institute for Clinical and Experimental Medicine (IKEM) in Prague of which in 84 (8.4%) cases for an uncommon diagnosis. Indicating the process in these cases is more difficult than in conventional diagnoses, because there is insufficient experience and the results are evaluated on small samples of patients.
Methods: A retrospective review of a group of patients with less frequent diagnoses who underwent orthotopic liver transplantation in IKEM. For selected diagnoses, we assessed the cumulative survival of patients and grafts.
Results: The most frequent diagnoses were polycystic liver disease, Budd-Chiari syndrome and epithelioid hemangioendothelioma. Annual cumulative survival reached 87%, 82%, 100%; five-year survival was 87%, 72% and 100%. In the group of six subjects transplanted for metastatic neuroendocrine tumours in the liver two patients died.
Conclusion: In the indicated cases, orthotopic livertransplantation brings excellent results in the group of uncommon diagnoses. Patients with metastases of neuroendocrine tumours in the liver represent a borderline indication. Orthotopic liver transplantation can be a good solution for some rare conditions. To succeed it is essential to carry out a careful pre-transplantation evaluation and examination. We have to always considerthe possibility of a conservative treatment.
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