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Solid organ transplantation—where we are and how far can we possibly go?

  • ICS congress 2015
  • Published:
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Abstract

Background

Solid organ transplants, e. g., kidney, pancreas, and liver, are well-established transplant methods at the Institute for Clinical and Experimental Medicine (IKEM), Czech Republic. Looking at the waiting lists, results, and also population in detail, some patients still suffer.

Methods

For the described reasons we have introduced some novel transplant methods since the second half of 2011. Kidney patients stay on dialysis; few get the best treatment method, which is live-donor kidney transplantation. Therefore, the live-donor program has been reorganized, kidney paired donation program introduced, miniinvasive donor nephrectomy used in all cases. Some liver patients suffer as well, especially small adults and children, also fulminant liver failure cases and those with multivisceral thrombosis. For these groups of patients we have introduced split-liver transplantation, ABO incompatible (AB0i) liver transplantation, live-donor liver transplantation, auxiliary liver transplantation, and also small bowel/multivisceral transplantation.

Results

Thanks to the changes, the number of live-donor kidney transplants has increased, the number of liver transplants doubled, many fulminant liver patients survived thanks to AB0i and auxiliary transplantation, and pediatric liver cases waiting time dropped dramatically. The small bowel transplant program started successfully with two multivisceral cases.

Conclusion

The novel methods and some program changes led to more transplants and also better outcomes. There is still room for further expansion and developments; there are for sure more transplant methods to be introduced. Also, the number of some transplants, e.g., live-donor kidney, still remains low.

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Abbreviations

Tx:

Transplantation

KTx:

Kidney transplantation

LDRTx:

Live-donor renal transplantation

LTx:

Liver transplantation

PTx:

Pancreas transplantation

SBTx:

Small bowel transplantation

MVTx:

Multivisceral transplantation

DCD:

Donor after circulatory death

DBD:

Donor after brain death

AB0i:

AB0 (blood group) incompatible

HCC:

Hepatocellular carcinoma

IKEM:

Institute for Clinical and Experimental Medicine

References

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Funding sources

The author did not receive any funding for this work.

Author information

Authors and Affiliations

  1. Institute for Clinical and Experimental Medicine, Praha 4, 140 21, Prague, Czech Republic

    Jiri Fronek MD PhD FRCS FICS FEBS MHA

Authors
  1. Jiri Fronek MD PhD FRCS FICS FEBS MHA
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Corresponding author

Correspondence to Jiri Fronek MD PhD FRCS FICS FEBS MHA.

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Conflict of interest

J. Fronek states that there are no conflicts of interest.

Ethical standards

All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.

Additional information

The supplement is dedicated to Jubilee World congress of International College of Surgeons 2015.

The publishing was sponsored by the Ministry of Health of the Czech Republic.

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Fronek, J. Solid organ transplantation—where we are and how far can we possibly go?. Eur Surg 48 (Suppl 2), 130–134 (2016). https://doi.org/10.1007/s10353-016-0403-7

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  • DOI: https://doi.org/10.1007/s10353-016-0403-7

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