Liver transplantation in the Novosibirsk Region: evolution of the program and its outcomes
- Authors: Porshennikov I.A.1,2, Pavlik V.N.1, Shchekina E.E.1, Kartashov A.S.1, Korobeinikova M.A.1, Yushina E.G.1, Bykov A.Y.1
-
Affiliations:
- State Novosibirsk Regional Clinical Hospital
- Novosibirsk State Medical University
- Issue: Vol 46, No 6 (2018)
- Pages: 560-571
- Section: ARTICLES
- URL: https://almclinmed.ru/jour/article/view/895
- DOI: https://doi.org/10.18786/2072-0505-201846-6-560-571
- ID: 895
Cite item
Full Text
Abstract
Objective: To assess early and late outcomes of the orthotopic liver transplantation (LTx) program in the Novosibirsk Region from August 2010 to June 2018.
Materials and methods: This retrospective study included 176 patients aged 41.5 ± 16.69 years (from 5 months to 69 years; median 44 years), who underwent 185 LTx procedures including nine retransplantations.
Results: Some particulars of vascular and biliary reconstruction in various LTx types are discussed. The incidence of vascular and biliary complications was 1.6% and 10.3%, respectively. The duration of stay in the intensive care unit was 7 ± 7.1 days (from 0 to 69 days, median 5) and mean total duration of hospital stay was 33 ± 18.1 days (from 1 to 136 days, median 30). Early graft dysfunction was observed in 28 (15.9%) of the recipients. Perioperative (up to 90 days) mortality was 4.5% (8 recipients, including one intra-operative death). There was zero mortality in the liver fragment recipients. The overall 5-year patient and graft survival rates were 71% and 65%, respectively.
Conclusion: The Novosibirsk Region has a well-established LTx program, with its outcomes being comparable to those of the leading Russian centers and large worldwide registries. In 2017, LTx prevalence was 12.9 per million of the population. Thus, the region has become one of the most provided with this type of medical care in the Russian Federation.
About the authors
I. A. Porshennikov
State Novosibirsk Regional Clinical Hospital; Novosibirsk State Medical University
Author for correspondence.
Email: porshennikov@oblmed.nsk.ru
Ivan A. Porshennikov – MD, PhD, Deputy Chief for Surgery SNRCH; Associate Professor, Chair of Hospital and Pediatric Surgery NSMU.
130 Nemirovicha-Danchenko ul., Novosibirsk, 630087, tel.: +7 (383) 315 96 76
РоссияV. N. Pavlik
State Novosibirsk Regional Clinical Hospital
Email: fake@neicon.ru
Vladimir N. Pavlik – MD, Surgeon, Organ Transplantation Department.
130 Nemirovicha-Danchenko ul., Novosibirsk, 630087
РоссияE. E. Shchekina
State Novosibirsk Regional Clinical Hospital
Email: fake@neicon.ru
Elena E. Shchekina – MD, Surgeon, Organ Transplantation Department.
130 Nemirovicha-Danchenko ul., Novosibirsk, 630087
РоссияA. S. Kartashov
State Novosibirsk Regional Clinical Hospital
Email: fake@neicon.ru
Aleksey S. Kartashov – MD, Surgeon, Organ Transplantation Department.
130 Nemirovicha-Danchenko ul., Novosibirsk, 630087
РоссияM. A. Korobeinikova
State Novosibirsk Regional Clinical Hospital
Email: fake@neicon.ru
Mariya A. Korobeinikova – MD, Surgeon, Organ Transplantation Department.
130 Nemirovicha-Danchenko ul., Novosibirsk, 630087
РоссияE. G. Yushina
State Novosibirsk Regional Clinical Hospital
Email: fake@neicon.ru
Ekaterina G. Yushina – MD, Surgeon, Organ Transplantation Department.
130 Nemirovicha-Danchenko ul., Novosibirsk, 630087
РоссияA. Yu. Bykov
State Novosibirsk Regional Clinical Hospital
Email: fake@neicon.ru
Aleksandr Yu. Bykov – MD, Head of Organ Transplantation Department.
130 Nemirovicha-Danchenko ul., Novosibirsk, 630087
РоссияReferences
- Starzl TE, Marchioro TL, von Kaulla KN, Hermann G, Brittain RS, Waddell WR. Homotransplantation of the liver in humans. Surg Ginecol Obstet. 1963;117:659–76.
- Поршенников ИА, Быков АЮ, Юданов АВ. 60 трансплантаций печени в Государственной Новосибирской областной клинической больнице: опыт одного центра. Бюллетень СО РАМН. 2014;34(6): 111–9.
- Готье СВ, Хомяков СМ. Донорство и трансплантация органов в Российской Федерации в 2017 году. X сообщение регистра Российского трансплантологического общества. Вестник трансплантологии и искусственных органов. 2018;20(2): 6–28. doi: 10.15825/1995-1191-2018-2-6-28.
- Niemi G, Breivik H. Epidural fentanyl markedly improves thoracic epidural analgesia in a lowdose infusion of bupivacaine, adrenaline and fentanyl. A randomized, double-blind crossover study with and without fentanyl. Acta Anaesthesiol Scand. 2001;45(2): 221–32. doi: 10.1034/j.1399-6576.2001.450214.x.
- Rogiers X, Bismuth H, Busuttil RW, Broering DC, Azoulay D, editors. Split liver transplantation. Theoretical and practical aspects. Berlin Heidelberg: Springer-Verlag; 2002. 158 p. doi: 10.1007/978-3-642-57523-5.
- Olthoff KM, Kulik L, Samstein B, Kaminski M, Abecassis M, Emond J, Shaked A, Christie JD. Validation of a current definition of early allograft dysfunction in liver transplant recipients and analysis of risk factors. Liver Transpl. 2010;16(8): 943–9. doi: 10.1002/lt.22091.
- Schmitz V, Schoening W, Jelkmann I, Globke B, Pascher A, Bahra M, Neuhaus P, Puhl G. Different cava reconstruction techniques in liver transplantation: piggyback versus cava resection. Hepatobiliary Pancreat Dis Int. 2014;13(3): 242–9. doi: 10.1016/S1499-3872(14)60250-2.
- Levi DM, Pararas N, Tzakis AG, Nishida S, Tryphonopoulos P, Gonzalez-Pinto I, Tekin A, Selvaggi G, Livingstone AS. Liver transplantation with preservation of the inferior vena cava: lessons learned through 2,000 cases. J Am Coll Surg. 2012;214(4): 691–8. doi: 10.1016/j.jamcollsurg.2011.12.039.
- Yerdel MA, Gunson B, Mirza D, Karayalçin K, Olliff S, Buckels J, Mayer D, McMaster P, Pirenne J. Portal vein thrombosis in adults undergoing liver transplantation: risk factors, screening, management, and outcome. Transplantation. 2000;69(9): 1873–81.
- Freise CE, Gillespie BW, Koffron AJ, Lok AS, Pruett TL, Emond JC, Fair JH, Fisher RA, Olthoff KM, Trotter JF, Ghobrial RM, Everhart JE; A2ALL Study Group. Recipient morbidity after living and deceased donor liver transplantation: findings from the A2ALL Retrospective Cohort Study. Am J Transplant. 2008;8(12): 2569–79. doi: 10.1111/j.1600-6143.2008.02440.x.
- Duailibi DF, Ribeiro MA Jr. Biliary complications following deceased and living donor liver transplantation: a review. Transplant Proc. 2010;42(2): 517–20. doi: 10.1016/j.transproceed.2010.01.017.
- Miyagi S, Kakizaki Y, Shimizu K, Miyazawa K, Nakanishi W, Hara Y, Tokodai K, Nakanishi C, Kamei T, Ohuchi N, Satomi S. Arterial and biliary complications after living donor liver transplantation: a single-center retrospective study and literature review. Surg Today. 2018;48(2): 131–9. doi: 10.1007/s00595-017-1515-9.
- Riediger C, Müller MW, Michalski CW, Hüser N, Schuster T, Kleeff J, Friess H. T-Tube or no T-tube in the reconstruction of the biliary tract during orthotopic liver transplantation: systematic review and meta-analysis. Liver Transpl. 2010;16(6): 705–17. doi: 10.1002/lt.22070.
- Sun N, Zhang J, Li X, Zhang C, Zhou X, Zhang C. Biliary tract reconstruction with or without T-tube in orthotopic liver transplantation: a systematic review and meta-analysis. Expert Rev Gastroenterol Hepatol. 2015;9(4): 529–38. doi: 10.1586/17474124.2015.1002084.
- Готье СВ, Мойсюк ЯГ, Попцов ВН, Корнилов МН, Ярошенко ЕБ, Погребниченко ИВ, Мойсюк ЛЯ, Сушков АИ, Малиновская ЮО, Цой ДЛ. Отдаленные результаты трансплантации трупной печени. Вестник трансплантологии и искусственных органов. 2014;16(3): 45–53. doi: 10.15825/1995-11912014-3-45-53.
- Kim WR, Lake JR, Smith JM, Schladt DP, Skeans MA, Harper AM, Wainright JL, Snyder JJ, Israni AK, Kasiske BL. OPTN/ SRTR 2016 Annual Data Report: Liver. Am J Transplant. 2018;18 Suppl 1:172–253. doi: 10.1111/ajt.14559.
- Evolution of LTs in Europe. European Liver Transplant Registry data [Internet]. Available from: http://www.eltr.org/Evolution-of-LTs-inEurope.html.