From December 1985 to December 1990 100 orthotopic liver transplantations were performed in 89 adult patients in the Department of Transplantation, Niguarda Hospital, Milan. Techniques of donor's and recipient's operation were, with some modifications, those described by Starzl and associates. Patients were divided into two series (the first 32 OLTX and the last 68) on the basis of substantial variation occurred in operative indications, graft preservation and immunosuppression. Cumulative survival was 63% after 12 months, 46% after 36 and 42 months; in the second group it was 78% after 12 and 24 months. In neoplastic patients survival was 49% at 18 months and 23% at 36 and 42 months; in the second group, however, which included 5 occasional findings in cirrhotic patients, survival at 24 months was markedly better (83%). Out of 13 patients who were HBsAg positive before OLTX with a follow-up of more than 3 months, 10 were anti-HDV positive. Five (38%) had HBV recurrence (4 co-infection HBV-HDV), 1 with histological picture of active liver cirrhosis after 8 months. The other 8 patients did not evidence recurrence. Six patients underwent OLTX for acute fulminant hepatitis and all were negative for HGsAg and anti-HCV: 3 survived and are in good condition. Survival was markedly influenced by the preoperative status of the patients and by intraoperative blood loss. The improved survival in the second group is accounted for, in conclusion, by a better surgical/intensive care experience and methodological differences: 1. emergency operations in terminal patients are now limited; 2. selection criteria are much more restrictive; 3. actual preservation solutions allow improved graft function; 4. multidrug immunosuppression permit a better control of rejection

Belli, L., De Carlis, L., Bettale, G., Del Favero, E., Rondinara, G., Belli, L., et al. (1991). Experience of the first 100 liver transplantations at the Niguarda Hospital in Milan [ESPERIENZA DEI PRIMI 100 TRAPIANTI EPATICI A MILANO-NIGUARDA]. CHIRURGIA, 4(6), 295-302.

Experience of the first 100 liver transplantations at the Niguarda Hospital in Milan [ESPERIENZA DEI PRIMI 100 TRAPIANTI EPATICI A MILANO-NIGUARDA]

De Carlis, L.;
1991

Abstract

From December 1985 to December 1990 100 orthotopic liver transplantations were performed in 89 adult patients in the Department of Transplantation, Niguarda Hospital, Milan. Techniques of donor's and recipient's operation were, with some modifications, those described by Starzl and associates. Patients were divided into two series (the first 32 OLTX and the last 68) on the basis of substantial variation occurred in operative indications, graft preservation and immunosuppression. Cumulative survival was 63% after 12 months, 46% after 36 and 42 months; in the second group it was 78% after 12 and 24 months. In neoplastic patients survival was 49% at 18 months and 23% at 36 and 42 months; in the second group, however, which included 5 occasional findings in cirrhotic patients, survival at 24 months was markedly better (83%). Out of 13 patients who were HBsAg positive before OLTX with a follow-up of more than 3 months, 10 were anti-HDV positive. Five (38%) had HBV recurrence (4 co-infection HBV-HDV), 1 with histological picture of active liver cirrhosis after 8 months. The other 8 patients did not evidence recurrence. Six patients underwent OLTX for acute fulminant hepatitis and all were negative for HGsAg and anti-HCV: 3 survived and are in good condition. Survival was markedly influenced by the preoperative status of the patients and by intraoperative blood loss. The improved survival in the second group is accounted for, in conclusion, by a better surgical/intensive care experience and methodological differences: 1. emergency operations in terminal patients are now limited; 2. selection criteria are much more restrictive; 3. actual preservation solutions allow improved graft function; 4. multidrug immunosuppression permit a better control of rejection
Articolo in rivista - Articolo scientifico
Surgery
Italian
1991
4
6
295
302
none
Belli, L., De Carlis, L., Bettale, G., Del Favero, E., Rondinara, G., Belli, L., et al. (1991). Experience of the first 100 liver transplantations at the Niguarda Hospital in Milan [ESPERIENZA DEI PRIMI 100 TRAPIANTI EPATICI A MILANO-NIGUARDA]. CHIRURGIA, 4(6), 295-302.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/205266
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