Living donor liver transplantation (LDLT) is the only treatment option for patients with end-stage liver disease (ESLD) where cadaveric donors are not available. In developing countries, the inception of LDLT programs remains a challenge. The first successful liver transplantation program in Pakistan started transplantation in 2012. The objective of this study was to report outcomes of 100 LDLT recipients in a developing country and to highlight the challenges encountered by a new LDLT program in a resource-limited setting. We retrospectively reviewed recipients who underwent LDLT between April 2012 and August 2014. Demographics, etiology, graft characteristics, and operative variables were assessed. Outcome was assessed on the basis of morbidity and mortality. All complications of 3 on the Clavien-Dindo grading system were included as morbidity. Estimated 1-year survival was calculated using Kaplan-Meier curves, and a Log-rank test was used to determine the significance. Outcomes between the first 50 LDLTs (group 1) and latter 50 LDLTs (group 2) were also compared. Median age was 46.5 (0.5-72) years, whereas the median MELD score was 15.5 (7-37). The male to female ratio was 4:1. ESLD secondary to hepatitis C virus was the most common indication (73% patients). There were 52 (52%) significant ( grade 3) complications. The most common morbidities were bile leaks in 9 (9%) and biliary strictures in 14 (14%) patients. Overall mortality in patients who underwent LDLT for ESLD was 10.6%. Estimated 1-year survival was 87%. Patients who underwent transplantation in the latter period had a significantly lower overall complication rate (36% versus 68%; P 5 0.01). Living donor liver transplantation (LDLT) was initially attempted to help reduce mortality in pediatric recipients waiting for size-matched deceased livers.

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Background: Acquired melanocytic nevi refers to an organized collection of melanocytes, neural crest in origin that usually appear after the first year of life. This is a benign condition of the skin and is commonly seen in about 80-100% of the general population. Epidemiologic data indicate that the number of nevi peak during the second and third decade of life and the incidence decreases with age. For the treatment of benign melanocytic nevi, various surgical and non-surgical treatment modalities have been reported in scientific literature. This study aimed to assess the cosmetic outcomes of shave excision for the treatment of acquired melanocytic nevi in a Pakistani tertiary care setting. Material and Methods:In total, 120 patients were enrolled in this study. All patients underwent shave excision upon being administered with intra-lesional local anesthesia (2% lignocaine with adrenaline). The lesion was shaved with a 15 number Bald Parker blade. Hemostasis was secured by pressure and 20% aluminum chloride solution. The final cosmetic outcomes (excellent, acceptable or poor) were assessed three months post-shave excision. Statistical analysis was performed using SPSS, v22. Data was evaluated by means of chi-square tests, and the phi coefficient. A P value of less than 0.05 was considered statistically significant to determine associations of age and gender to cosmetic outcomes. Results:The mean age of included patients was 29.7±7.4 years. There were 30 (25%) male and 90 (75%) female patients. Out of these, 35 (29.2%) patients had excellent outcome, 75 (62.5%) patients had acceptable and 10 (8.3%) patients had poor outcome. The associations of gender and age to dermatological outcomes post-excision were significant (P<0.001). Sufficient evidence was collated to determine a relationship between age (Pearson Chi-Square = 113.94) and gender (Pearson Chi-Square = 97.143) to cosmetic outcomes (P<0.001). The phi (ϕ) coefficient also confirmed the significance of positive associations between the cosmetic outcomes to gender and age (ϕ= 0.974). Conclusion:Shave excision presents as an exceedingly useful and inexpensive method for the removal of acquired melanocytic nevi especially in a low and middleincome country like Pakistan.