1. BRAZILIAN SINGLE CENTER SURVIVAL RATES AFTER LIVER
TRANSPLANT DUE TO FULMINANT HEPATIC FAILURE
Andre I. David, Maria Paula V.Coelho, Sergio P. Meira Filho, Marcio D. De Almeida, Bianca Della-Guardia, Marcelo B. Rezende, Rogerio C. Afonso, Ben-Hur Ferraz-Neto
Transplant, Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil Background: Fulminant hepatic failure (FHF) represents 5% of liver failure in UNOS-Data and 17.4% in our program. FHF are prioritized for a liver graft, but donors are a critical issue (7.0 donors/million).This high risk situation could compromise results.
Purpose: analyze results of liver transplant (OLT) for FHF within the last 3 years. Casuistic and Methods: Retrospectively were analyzed twenty six patients transplanted from May 2005 to September 2008 in a single center. Results: Donor characteristics (medians): age 40.5 years, 42.3% with 1 vasopressor, 38.5% with >1 vasopressors, BMI was 24.0 kg/m2, sodium 155 mEq/l, ALT 39 U/L, AST 53.5 U/L, cardiac arrest 42.3 % and controlled infection 19%. Causes of death: 42.3% cerebral bleeding, 38.5% cranioencephalic trauma, 3.8% ischemic cerebral vascular accident and 11.5% others. Grafts characteristics: 73.1% grade 1 liver steatosis, 19.2% grade 2, 3.8% had grade 3. Arterial anomalies in 19.2%, median cold and warm ischemia time: minutes and 54 minutes.
Recipient's characteristics (medians): age: 44 years, intra-operatory time: 400 minutes, intra-operatory blood transfusion: 2 red blood packages, ICU stay: 11 days after transplant, length of hospital stay: 19.5 days. Three recipients (11.5%) needed retransplant. Five patients (19.2%) died post OLT. One year graft and patient survival rate was 73,08% and 82,61% respectively. Survival curve from State of Sao Paulo, shows 55,36% and 58,8%, respectively for grafts and patients. Conclusion Liver transplant has satisfactory survival rates in FHF in specialized center.
References
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Sass, DA; Shakil, AO. Fulminant Hepatic Failure.. Liver Transplantation, 11, (6): , 2005.