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Comparison between the results of livertransplantation from living related donors compared to cadaveric donors : A Retrospective Study

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

General Surgery

Advisors

Galal, Samir , Qurashi, Ezz-El-Din, Nashed, George A.

Authors

El-Ghazali, Shadi Tareq M.

Accessioned

2017-04-26 12:43:25

Available

2017-04-26 12:43:25

type

M.Sc. Thesis

Abstract

Objectives: To compare between the results of liver transplantation after living related transplantation, as compared to cadaveric liver transplantation. This comparison was focusedmainly on post-operative complications following each type of transplantation. The results of the study were in turn compared to the results recorded in the scientific literature regardingthis subject. Methods: The study included 20 patients who underwent Liver transplantation from July 2004 to July 2005 in the Medical School of University of Hannover (MHH) in its transplantation unit, under the supervision of Prof. Jurgen Klempnaeuer the head of thisdepartment.These patients were divided into 2 groups; Group A: 10 patients who underwent Cadaveric donor Liver Transplantation (CLT), and Group B: 10 patients who underwent Living Relateddonor Liver Transplantation (LRLT). These patients were followed up to detect any of the following complications: rejection episodes, primary non-function, biliary complications(stenosis or leakage), vascular Complications (bleeding or thrombosis), recurrence of original disease, right-sided pleural effusion, donor complications in cases of LRLT.Results: The results of this study were statistically insignificant, because of the limited number of cases used. But the results as a whole correspond to the general trend recorded byrecent scientific literature. The incidence of acute rejection episodes (AREs) in this study was 20% for CLT and 10% for LRLT, while the incidence of primary non-function (PNF)for CLT was 10% and 0% for LRLT. Biliary leakage had an incidence of 10% of LRLT cases, with no occurrence in CLT cases. The study showed an incidence of 40% of anastomotic biliary strictures in LRLT and 10% of anastomotic biliary strictures in CLTgroup. 20% of patients suffered from post-operative bleeding in the CLT group, while no patients suffered from this complication in the LRLT group. Hepatic artery thrombosis occurred in 10% of LRLT and didn’t occur in CLT. HCV recurrence was 50% of totalpatients (2 patients) of the CLT group while the only patient who had HCV infection in the LRLT group had recurrence. HCC recurrence, on the other hand, was 50% of total patients(2 patients) of the CLT group, while no patients of the LRLT group had HCC recurrence.The overall donor operative morbidity rate was 40%, 20% minor complications; 10% with wound infection and 10% with atelectasis, while the other 20% were major complications (all biliary complications).Conclusion: LRLT, which is the only option we have in Egypt, has great risks and by itself cannot meet the great need of organs that we have here in Egypt. It can be a good complementary program besides a CLT program, which stands out as the main system ofliver transplantation in the western world. All our efforts should be directed to trying to enforce legislation for cadaveric transplantation in Egypt.

Issued

1 Jan 2007

DOI

http://dx.doi.org/10.21473/iknito-space/33846

Details

Type

Thesis

Created At

31 Jan 2023