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  1. Home /
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  3. Vol 46 No 1 (2015) /
  4. Original Articles

An experience of liver transplantation in Latin America: a medical center in Colombia

  • Abstract
  • Keywords
  • Author Biographies
  • References

Abstract

Objectives:

Liver transplantation is the treatment of choice for acute and chronic liver failure, for selected cases of tumors, and for conditions resulting from errors in metabolism. This paper reports the experience of a medical center in Latin America.

Methods:

Were conducted 305 orthotopic liver transplantations on 284 patients between 2004 and 2010. Of these patients, 241 were adults undergoing their first transplantation.

Results:

The average age of patients was 52 years old, and 62% of the individuals were male. The most common indication was alcoholic cirrhosis. The rate of patient survival after 1 and 5 years was 82 and 72% respectively. The rate of liver graft survival after 1 and 5 years was 78 and 68% respectively. The main cause of death was sepsis. Complications in the hepatic artery were documented for 5% of the patients. Additionally, 14.5% of the patients had complications in the biliary tract. Infections were found in 41% of the individuals. Acute rejection was observed in 30% of the subjects, and chronic rejection in 3%.

Conclusion:

In conclusion, liver transplantation at our medical center in Colombia offers good mid-term results, with a complication rate similar to that reported by other centers around the world.

Authors

  • Oscar Santos - Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia. - Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia
  • Mauricio Londoño Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia
  • Juan Marin - Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia - Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia
  • Octavio Muñoz - Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia - Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia
  • Alvaro Mena Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia
  • Carlos Guzman Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia
  • Sergio Hoyos - Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia - Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia
  • Juan Restrepo - Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia - Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia
  • Maria Arbelaez Epidemiology Research Group, National Faculty of Public Health, University of Antioquia, Medellin, Colombia
  • Gonzalo Correa - Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia - Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia

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Keywords

  • Liver transplantation
  • cirrhosis
  • liver graft
  • rejection
  • immunosuppressive

Author Biographies


, - Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia. - Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia
Internal Medicine, Hepatology and Liver Transplant, Pablo Tobon Uribe Hospital, Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia

, Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia
Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia

, - Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia - Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia
Internal Medicine, Hepatology and Liver Transplant, Pablo Tobon Uribe Hospital, Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia

, - Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia - Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia
Internal Medicine, Hepatology and Liver Transplant, Pablo Tobon Uribe Hospital, Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia

, Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia
Liver Transplant, Pablo Tobon Uribe Hospital

, Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia
Liver Transplant, Pablo Tobon Uribe Hospital

, - Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia - Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia
Liver Transplant, Pablo Tobon Uribe Hospital

, - Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia - Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia
Internal Medicine, Hepatology and Liver Transplant, Pablo Tobon Uribe Hospital, Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia

, Epidemiology Research Group, National Faculty of Public Health, University of Antioquia, Medellin, Colombia
Epidemiology Research Group, National Faculty of Public Health, University of Antioquia, Medellin, Colombia

, - Hepatology and Liver Transplantation Unit, Pablo Tobon Uribe Hospital, Medellin, Colombia - Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia
Internal Medicine, Hepatology and Liver Transplant, Pablo Tobon Uribe Hospital, Gastrohepatology Research Group, University of Antioquia, Medellin, Colombia

References

Murray K, Carithers R. AASLD Practice Guidelines: Evaluation of the Patient for Liver Transplantation. Hepatology. 2005;41:1407–1432.

Starzl T, Groth C, Brettschneider L, Pen I, Fulginiti V, Moon J, et al. Orthotopic homotransplantation of the human liver. Ann Surg. 1968;168:392–415.

Thuluvath P, Guidinger M, Fung J, Johnson L, Rayhill S, Pelletier S. Liver Transplantation in the United States, 1999-2008. Am J Transplant. 2010;10:1003–1019.

Busuttil R, Klintmalm G. Transplantation of the liver. Second edition. Elsevier; 2005. pp. 833–852.

Gutierrez J, Guzman C, Correa G, Restrepo J, Sepulveda E, Yepes N, et al. Liver transplantation in Medellin, Colombia: initial experience. Transplant Proc. 2004;36:1677–1680.

National Institutes of Health Consensus Development Conference Statement liver transplantation--June 20-23, 1983. Hepatology. 1984;4:S107–S110.

European Liver Transplant Registry until December 2010 [January 2012]; a Available from: http://www.eltr.org.

Buckel E, Uribe M, Brahm J, Silva G, Ferrario M, Godoy J, et al. Outcomes of Orthotopic Liver Transplantation in Chile. Transplant Proc. 2003;35:2509–2510.

Castro R, Deisanti D, Seva-Pereira T, et al. Survival before and after model for end-stage liver disease score introduction on the Brazilian liver transplant waiting list. Transplant Proc. 2010;42(2):412–416.

Mies S, Baia CE, Almeida M, Della Guardia B, Ferraz L, Lallee M, et al. Twenty years of liver transplantation in Brazil. Transplant Proc. 2006;38(6):1909–1910. [PubMed]

Arnow PM. Infections following orthotopic liver transplantation. HPB Surg. 1991;3:221–232.

Pfitzmann P, Nussler N, Hippler-Benscheidt M, Neuhaus R, Neuhaus P. Long-term results after liver transplantation. Transplant International, 2008;21:234–246.

Kotton C, Kumar D, Caliendo A, Asberg A, Chou S, Snaydman D, et al. International Consensus Guidelines on the Management of Cytomegalovirus in Solid Organ Transplantation. Transplantation. 2010;89:779–795.

Pappas P, Kauffman C, Andes D, Benjamin D Jr, Calandra D, Edwards D, et al. Clinical Practice Guidelines for the Management of Candidiasis: 2009 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases. 2009;48:503–535.

Instituto Nacional de Salud . Guidelines for the programmatic management of multidrug-resistant tuberculosis in Colombia. 2010.

Singh N, Paterson DL. Mycobacterium tuberculosis infection in solid-organ transplant recipients: impact and implications for management. Clin Infect Dis. 1998;27:1266–1277.

Duffy JP, Hong JC, Farmer D, Ghobrial R, Yersiz H, Hiatt J, et al. Vascular complications of orthotopic liver transplantation: experience in more than 4,200 patients. J Am Coll Surg. 2009;208(5):896–903.

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Stratta RJ, Wood RP, Langnas AN, Hollins R, Bruder K, Donovan J, et al. Diagnosis and treatment of biliary tract complications after orthotopic liver transplantation. Surgery. 1989;106:675–683.

Greif F, Bronsther OL, Van Thiel DH, Casavilla A, Iwatsuki S, Tzakis A, et al. The incidence, timing, and management of biliary tract complications after orthotopic liver transplantation. Ann Surg. 1994;219:40–45.

Rerknimitr R, Sherman S, Fogel E, Kalayci C, Lumeng L, Chalasani N, et al. Biliary tract complications after orthotopic liver transplantation with choledochocholedochostomy anastomosis: endoscopic findings and results of therapy. Gastrointest Endosc. 2002;55:224–231.

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Published
2015-03-30
Submitted
2013-08-10
| 523 |
How to Cite
Santos, O., Londoño, M., Marin, J., Muñoz, O., Mena, A., Guzman, C., Hoyos, S., Restrepo, J., Arbelaez, M., & Correa, G. (2015). An experience of liver transplantation in Latin America: a medical center in Colombia. Colombia Médica, 46(1), 8-13. https://doi.org/10.25100/cm.v46i1.1400
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Vol 46 No 1 (2015)
Section
Original Articles

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