RESUMO
From July 4, 1999, when a liver transplantation program was started in Cuba, to December 30, 2007, we performed 125 procedures in 115 patients. The most frequent reasons for transplantation were cirrhosis caused by hepatitis C virus (29%) and alcoholic cirrhosis (17.2%). Two patients received simultaneous liver-kidney transplants. Sixty-seven patients were males, and the patient ages ranged from 12 to 74 years. The average surgical time was 6 hours, and cold ischemia time was 4 to 14 hours. The average blood consumption was 1630 mL; 2900 mL of plasma and 8 units of platelets were used in 7 cases. Immunosuppression was mainly cyclosporine, mycophenolate mofetil, and prednisone. Acute cellular rejections were treated in almost all cases with 3 doses of methylprednisolone. The most frequent complications were biliary (15%), hepatic arterial thrombosis (6%), postsurgical bleeding (8%), acute cellular rejection (20%), and ductopenic rejection (2%). The overall 1-year survival was 74.7%.
Assuntos
Transplante de Fígado/estatística & dados numéricos , Cuba , Feminino , Humanos , Imunossupressores/uso terapêutico , Hepatopatias/classificação , Hepatopatias/cirurgia , Transplante de Fígado/imunologia , Transplante de Fígado/métodos , Masculino , Complicações Pós-Operatórias/epidemiologia , Estudos RetrospectivosRESUMO
In July 1999 we began a liver transplant program that to October 2005 has included 100 liver transplants in 92 patients, eight retransplants, and two combined liver and kidney grafts. Twelve transplants were in pediatric patients, who showed a 92% survival rate in the first year. Fifty-four percent of the patients were male and 46% female. The most frequent etiologies of cirrhosis were 27% hepatitis virus C, 18% alcoholic, 13% cryptogenic, and 11% autoimmune. In 95% of the patients, we preserved the retrohepatic vena cava. The bile duct was reconstructed with a Kehr tube in 46% of patients with 31% using end-to-end suture with a tutor and 15% an end-to-end suture without a tutor. A hepaticojejunostomy was performed in 8%. The immunosuppression included cyclosporine (Neoral) or Prograf combined with mycophenolate mofetil or mycophenolate sodium and steroids. The most frequent biliary complications were local anastomosis leaks (6%) and stenosis (10%). The overall 1-year survival rate was 72%.
Assuntos
Hepatopatias/cirurgia , Transplante de Fígado/estatística & dados numéricos , Cuba , Humanos , Transplante de Rim/estatística & dados numéricos , Hepatopatias/classificação , Reoperação , Estudos Retrospectivos , Veia Cava Inferior/cirurgiaRESUMO
From July 4, 1999, when a liver transplantation program was started in Cuba, to October 2003, 66 procedures had been performed in 60 patients. The most frequent reason was cirrhosis caused by hepatitis C virus (29%), and alcoholic cirrhosis (22%). Two patients received simultaneous liver-kidney transplants. Half of the patients were men. Patient ages ranged from 12 to 62 years; the average surgical time was 6 hours; and cold ischemia time was 4 to 14 hours. The average blood consumption was 2033 mL; 2900 mL of plasma and 8 units of platelets were used in 7 cases. Immunosuppression was mainly cyclosporine (Neoral), mycophenolate mofetil or azathioprine, and prednisone. Acute cellular rejections were treated in almost all cases with 3 doses of methylprednisolone. The most frequent complications were biliary (24%), hepatic arterial thrombosis (12%), post-surgical bleeding (10%), acute cellular rejection (24%), and ductopenic rejection (2%). The overall 1-year survival rate was 73.7%.