Long-Term Outcome of Patients Undergoing Liver
Transplantation at Rajavithi Hospital, Thailand
Somboon Subwongcharoen MD, MSc*, Sa-ard Treepongkaruna MD*,
Kawin Leelawat MD, PhD*, Kanchana Ruksakul MD**
Affiliation :
* Department of Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
** Department of Anesthesiology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
Objective : Examine long-term outcome and survival of patients with liver transplantation at Rajavithi Hospital, a small-
volume transplant center in Bangkok, Thailand.
Material and Method: Between May 1996 and December 2010, 21 liver transplantations were performed. Piggyback
technique and portal vein flushing with one liter of cold normal saline was used to prevent reperfusion injury. Color Doppler
ultrasound was performed routinely. Data collection included demographic data, complications, operation time, ischemic
time, duration of stay in intensive care unit (ICU), hospitalization period, and survival.
Results : There were two cases withdrawn from immunosuppressant drugs due to loss of follow-up and recidivism. Late
death in three patients was from bleeding after hemiarthroplasty, chronic rejection, and lymphoma. Overall, 5-year and
10-year survival were 62% and 42% respectively. Biliary complication rate was 9.5%. Two cases were under early reoperation
due to bleeding from hepatic artery and retrohepatic vein. Hepatic vein occlusion was found in one case that had underlying
Budd Chiari. One case with hepatocellular carcinoma, 10 nodules in both lobes of liver had survived more than three years
after transplantation.
Conclusion : Liver transplantation is a high-cost procedure. Good long-term results depend on expensive drugs, skilled
surgeons, state-of-the-art equipment, and good team work. Policy and support from the government play an important role
for successful transplantation, especially in developing countries.
Keywords : Liver transplantation, Long-term survival, Immunosuppression, Hepatocellular carcinoma
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