CHAPTER 4 LIVER TRANSPLANTATION Editors: Dr Ganesalingam A/L Kanagasabai Expert panel: Dr Ganesalingam A/L Kanagasabai (Chairperson) Professor Dr Lee Way Seah Dr Lim Chooi Bee Dr Lim Kin Foong Dr Haniza Binti Omar

Table Stock and Flow of Liver Transplantation, Year * ** New transplant patients Deaths Re-Transplant Lost to follow up Functioning graft at 31st December Figure Stock and Flow of Liver Transplantation, Number of patients (n) Year New patients Alive at 31st Dec *1 patient who was alive until 05/12/1997 is recorded dead with missing date of death ** 1 patient transplanted in 2003 is recorded as dead with missing date of death

Table Distribution of Patients by Place of Transplant, Place of Transplant Year (No.) TOTAL Local Overseas TOTAL Table Distribution of Patients by Centres for Liver Transplantation, Transplant Centre Year (No.) TOTAL Sime Darby Medical Centre, Subang Jaya Hospital Selayang University of Malaya Medical Centre Royal Children's Hospital, Brisbane National University Hospital, Singapore Queensland Liver Transplant Service, Australia Kings College Hospital, UK Tianjin, China Asian Centre for Liver Disease & Transplantation, Singapore TOTAL

Table Distribution of Patients by Gender, Gender Year (No.) TOTAL Male Female TOTAL Figure Distribution of Patients by Gender, Number of patients (n) Year Male Female

Table Distribution of Patients by Ethnic Group, Ethnic group Year (No.) TOTAL Malay Chinese Indian Others TOTAL Figure Distribution of Patients by Ethnic Group, Number of patients (n) Year Malay Chinese Indian Others

Table Distribution of Patients by Age, Age Group* Year (No.) TOTA L < ≥ TOTAL Mean SD Median Minimum months months months Maximum

Table Primary Diagnosis, (N=100) Primary diagnosis Year (No.) TOTAL Biliary atresia Metabolic liver disease Cholestatic liver disease Primary biliary cirrhosis Primary sclerosing cholangitis Autoimmune hepatitis Chronic hepatitis B Chronic hepatitis C Alcoholic liver disease Malignancies Acute liver failure Idiopathic/ Cryptogenic Others TOTAL ** 7 patients have more than one primary disease

Table Indication for Transplantation, (N=100) Indication for transplantation Year (No.) TOTAL Recurrent encephalopathy Uncontrolled bleeding varices Intractable ascites Spontaneous bacterial peritonitis Poor liver function Malignancy Unacceptable quality of life Failure to thrive and growth retardation in paediatric patients Others No data TOTAL ** 33 patients had 1 indication for transplant, 63 had more than 1 indication for transplantation

Table Recipients’ Blood Group, Blood group Year (No.) TOTAL A B AB O No Data TOTAL

Table Distribution of Patients by Type of Donors, Type of donor Year (No.) TOTAL Cadaveric Living Related - Mother Living Related - Father Living Related - Daughter Living Related - Son Living Related - Brother Living Related - Sister Living Related - Monozygotic twin Living Related - Dizygotic twin Living Related - Others Living Related - Emotionally Living Unrelated TOTAL patients

Table Immunosuppresive Drug Treatment at Transplantation, (N=100) Immunosuppressive drugs Year (No.) TOTAL Steroids Azathioprine Cyclosporin A Tacrolimus (FK506) Mycophenolate Mofetil (MMF) Rapamycin Monoclonal/Polyclonal Antiodies Anti IL26 Antibodies Others No Data TOTAL patients Note: 22 patients had 1 type if drug, 41 patients had 2 types, 23 patients had 3 types.

Table Patient Survival by Year of Transplant, (N=100) Interval (months) Year of transplant % SurvivalSE% SurvivalSE Figure Patient Survival by Year of Transplant,

Table Patient Survival by Gender, (N=100) Interval (months) Gender MaleFemale % SurvivalSE% SurvivalSE Figure Patient Survival by Gender,

Table Patient Survival by Age Group, (N=100) Interval (months) Age Group 0-9 years≥10 years % SurvivalSE% SurvivalSE Figure Patient Survival by Age Group,

Table Distribution of Patients by Cause of Death, (N=100) Year TOTAL Causes of deathNo. Graft failure Chronic graft rejection Intra-abdominal Bleeding Peritonitis CMV Pneumonia Decompensated liver cirrhosis Intracranial hemorrhage Malignancy Variceal bleed Pneumonia and respiratory failure Post transplant lymphoproliferative disease Sepsis Acute liver failure secondary to portal vein thrombosis post liver transplant 11 End stage liver failure recurrent ascending cholangitis 11 Acute or Chronic Liver Failure112 Viral bronchopneumonia11 Hepatitis B11 Cholethiasis11 Unknown TOTAL