Resumen de Trasplante hepático en adultos: casuística de Clínica Alemana de Santiago
Juan Hepp Kuschel, Horacio Ríos R, Leopoldo Suárez P, Mónica Zaror Z, Marta Quiroga G, Gabriela Rodríguez M, Rodrigo Valderrama L, Roberto Humeres, Franco Innocenti, Edgar Sanhueza, Rodrigo Zapata L, Rubén Cárdenas S, José M Palacios J, Juan Abarca Z, Carlos Montalván R, Luis M Noriega R, Domingo Videla T, Enrique Reynolds, Ricardo Espinoza, Renato Sandoval, Montserrat Rius A
Background: The success of orthotopic liver transplantation (OLT) has resulted in its widespread use for different liver diseases. Aim: To report our 8 years experience with adult OLT at Clinica Alemana de Santiago. Patients and methods: In all transplantations done at the center, we recorded patient's overall data and survival, postoperative medical and surgical complications and causes of death. Results: Between November 1993 and September 2001, 51 consecutive OLT were performed in 44 patients (22 females, median age 45 years old). Thirty eight patients presented with chronic and 6 with acute or sub-acute liver failure. Cryptogenic cirrhosis and hepatitis C infection were the most common causes for OLT. Postoperative bleeding and extra-hepatic biliary complications were seen in 17.6 and 21.5% of cases respectively. Acute rejection, bacterial infections, CMV infection or disease and post OLT hemodialysis were the most common medical complications (51, 31, 19.6 and 19.6% of cases respectively). The overall 1 and 5 years survival rates were 80% and 73% respectively. Considering exclusively the last 22 OLT performed since January 1999, the 1 year survival rate has improved to 91%. Conclusions: Liver transplantation in Chile provides a good long term survival with acceptable morbidity, due to a multidisciplinary approach management. The survival rates have improved over the last few years probably due to better surgical techniques, ICU care and immunosuppression. These overall results are comparable with those from other Centers in developed countries (Rev Méd Chile 2002; 130: 779-86)
