Application of Various Surgical Techniques in Orthotopic Liver Transplantation:  a 10-year Experience at a Single Center

Abstract

BackgroundLiver transplantation (LT) is considered the only curative treatment for end-stage liver disease (ESLD), and the surgical techniques of LT have continually evolved and have been modified. In this study, we prospectively analyzed a single-center case series in our center and compared the advantages and disadvantages of each method.MethodsIn total, 1,029 patients with OLT at our department were enrolled in this study. The recipient perioperative data were assessed and analyzed. Three types of LT techniques were utilized: modified classic, modified piggy-back (MPB) and classic piggy-back (PB) orthotopic LT, corresponding to groups A, B and C.ResultsCirrhosis was the most prevalent condition in group B, while tumors tended to be more common in group A. Patients in group C were in poorer general condition with higher creatinine, total bilirubin and PT-INR (P = 0.029, 0.011 and 0.026, respectively). Two hundred ninety-five patients had previous abdominal surgery, and the proportion was higher in group B (P = 0.017). The cold ischemia time in group B was longer than those in the other two groups (P<0.001). The mortality rate was 7.9% within 30 days and 11.7% within 90 days. Most of the deaths were not technique-related.ConclusionThe advantages and disadvantages are different for these three surgical techniques. A reasonable operation technique should be adopted considering the patient's unique condition to ensure the stability of hemodynamics.