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Living Donor Liver Transplantation in South Asia: Single Center Experience on Intermediate-Term Outcomes

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Abstract

Background

There is paucity of data on intermediate-term post liver transplant outcomes from South Asia. The objective of this study was to determine survival outcomes in patients who underwent living donor liver transplantation (LDLT) in a busy liver transplant center in Pakistan.

Methods

This study was a review of patients who underwent LDLT between 2012 and 2016. A total of 321 patients were included in this study. Early (within 90 days) and late (>90 days) morbidity and mortality was assessed. Estimated 1- and 4-year survival was determined.

Results

Median age was 48 (18–73) years. Male to female ratio was 4.5:1. Out of total 346 complications, 184 (57.3%) patients developed 276 (79.7%) complications in early post-transplant period, whereas there were 70 (21.3%) late complications. Most common early complication was pleural effusion in 46 (16.6%) patients. Biliary complications were the most common late complication and were seen in 31/70 (44.2%) patients. Overall 21.4% patients had a biliary complication. The 3-month mortality was 14%. The estimated 1- and 4-year OS for a MELD cutoff of 30 was 84.5 versus 72 and 80 versus 57% (P = 0.01). There was no donor mortality.

Conclusion

Acceptable intermediate-term post-transplant outcomes were achieved with LDLT. There is a need to improve outcomes in high-MELD patients.

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Author information

Authors and Affiliations

  1. Department of HPB Surgery and Liver Transplantation, Shifa International Hospital, Sector H-8/4, Pitras Bukhari Road, Islamabad, Pakistan

    Faisal S. Dar, Abu Bakar H. Bhatti, Ammal I. Qureshi, Nusrat Y. Khan, Zahaan Eswani & Haseeb H. Zia

  2. Department of Anesthesiology, Shifa International Hospital, Islamabad, Pakistan

    Eitzaz U. Khan & Nasir A. Khan

  3. Department of Radiology, Shifa International Hospital, Islamabad, Pakistan

    Atif Rana & Rashid Nazer

  4. Department of Gastroenterology and Hepatology, Shifa International Hospital, Islamabad, Pakistan

    Najmul H. Shah & Mohammad Salih

Authors
  1. Faisal S. Dar
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  2. Abu Bakar H. Bhatti
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  3. Ammal I. Qureshi
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Correspondence to Abu Bakar H. Bhatti.

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Dar, F.S., Bhatti, A.B.H., Qureshi, A.I. et al. Living Donor Liver Transplantation in South Asia: Single Center Experience on Intermediate-Term Outcomes. World J Surg 42, 1111–1119 (2018). https://doi.org/10.1007/s00268-017-4259-1

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  • DOI: https://doi.org/10.1007/s00268-017-4259-1

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