Result of orthotopic liver transplantation at King Chulalongkorn Memorial Hospital: the first series from Thailand

Abstract

Liver transplantation is one of the best treatments for advanced liver disease since it can prolong the patient's survival. In Thailand, the first liver transplantation was performed in 1987 at King Chulalongkorn Memorial Hospital. Up till now the authors have transplanted the most in Thailand, having done more than 30 cases. From 1997 to 2002, there were 20 cases of liver transplantation and this is the result presented. The authors classified the patients into 2 groups, according to primary indications for transplantation. Patients with cirrhosis were included in group I and patients with hepatocellular carcinoma were included in group II. The one year survival in group I and II was 64 per cent and 29 per cent respectively. Mortality rate in the cirrhotic group was high during the first 3 months post transplant. The reason for a high mortality rate in the hepatocellular carcinoma group may be secondary to the advanced stage of cancer and the poor condition of the patients. However, the acute rejection rate in the present series of 25 per cent is relatively low compared to other series and this may need further study. The one year survival rate in patients who received a new liver from 1997 to 1999 compared to 2000-2002 was 33 per cent and 54 per cent respectively. This showed an improvement in the result of liver transplantation in Thailand. In conclusion, this report showed a satisfactory result of liver transplantation. The main problem with liver transplantation in Thailand is that potential donors do not understand the problems which leads to few donors. There is also a shortage of skilled personnel, budget, and the appropriate instruments.