Liver Transplantation at KFSHRC: Achievement and Challenges

Mi, Al Sebayel; Fa, Abaalkhail; Ha, B. Y.; Ah, Abdo; Elsiesy, Hussien; Ms, Al; Ym, El Sheikh; Bs, Hegab; Ym, Kamel; Tt, AlGoufi; Hh, Hasssan; Mm, Burdelski; Al, Ma; Abdelfattah, Mohamed Rabei; Km, Attallah; Tz, Mahmood; Yz, Saleh; Fz, Eldeen; Broering, Dc

doi:10.5144/0256-4947.2014.103

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…HCV-related cirrhosis was the main LT indication in adult patients in this study (35%). This is comparable to other published studies from Argentina, the United States, and Saudi Arabia, where HCV was the most common LT indication in adult patients and represented 35%, 37.4%, and 38% of their patients, respectively[ 2 , 7 , 17 ]. However, the European Liver Transplant Registry reported a lower percentage of HCV-related cirrhosis (13%) among their population[ 3 ].…”

Section: Discussionsupporting

confidence: 89%

“…This study found that most patients who required LT were adults (71.8%). Similarly, several studies reported that a higher number of adult patients underwent LT than pediatric patients[ 2 , 7 , 12 , 13 ]. The reason behind this finding might be related to the fact that most centers started LT services in adults first, followed by the pediatric population.…”

Section: Discussionmentioning

confidence: 98%

“…Many countries have built respectable reputations and experience in LT, including Turkey and India[ 5 , 6 ]. Moreover, some Gulf Cooperation Council countries and neighboring countries, including Saudi Arabia and Iran, have provided this surgical service for the public for many years[ 9 - 7 ]. Other countries have recently started developing their capabilities to provide LT services, such as Kuwait and Oman[ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Multiple reports about LT experiences have been published from several countries worldwide[ 3 , 4 , 7 ]. However, there are no reports studying the details of patients from Bahrain who went overseas for LT.…”

Section: Introductionmentioning

confidence: 99%

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Pediatric and adult liver transplantation in Bahrain: The experiences in a country with no available liver transplant facilities

Isa,

Alkharsi,

Khamis

et al. 2024

World J Transplant

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BACKGROUND Liver transplantation (LT) is a life-saving procedure for patients with end-stage liver disease and has become the standard and most effective treatment method for these patients. There are many indications for LT that vary between countries and settings. The outcome of LT depends on the available facilities and surgical expertise, as well as the types of liver graft donors available. AIM To assess the clinical characteristics of patients from Bahrain who underwent LT overseas, and analyze factors affecting their survival. METHODS In this retrospective cohort study, we reviewed the medical records and overseas committee registry information of all pediatric and adult patients who were sent overseas to undergo LT by the Pediatric and Medical Departments of Salmaniya Medical Complex and Bahrain Defence Force Hospital via the Overseas Treatment Office, Ministry of Health, Kingdom of Bahrain, between 1997 and 2023. Demographic data, LT indication, donor-recipient relationship, overseas LT center, graft type, post-LT medications, and LT complications, were collected. Outcomes measured included the overall and 5-year LT survival rate. Fisher’s exact, Pearson χ 2, and Mann-Whitney U tests were used to compare the pediatric and the adults’ group in terms of clinical characteristics, donor-recipient relationship, medication, complications, and outcome. Survival analysis was estimated via the Kaplan-Meier’s method. Univariate and multivariate analyses were used to detect predictors of survival. RESULTS Of the 208 eligible patients, 170 (81.7%) were sent overseas to undergo LT while 38 (18.3%) remained on the waiting list. Of the 170 patients, 167 (80.3%) underwent LT and were included in the study. The majority of the patients were Bahraini (91.0%), and most were males (57.5%). One-hundred-and-twenty (71.8%) were adults and 47 (28.3%) were children. The median age at transplant was 50.0 [interquartile range (IQR): 14.9–58.4] years. The main indication for pediatric LT was biliary atresia (31.9%), while that of adult LT was hepatitis C-related cirrhosis (35.0%). Six (3.6%) patients required re-transplantation. Most patients received a living-related liver graft (82%). Pediatric patients received more living and related grafts than adults (P = 0.038 and P = 0.041, respectively), while adult patients received more cadaveric and unrelated grafts. Most patients required long-term immunosuppressive therapy after LT (94.7%), of which tacrolimus was the most prescribed (84.0%), followed by prednisolone (50.7%), which was prescribed more frequently for pediatric patients (P = 0.001). Most patients developed complications (62.4%) with infectious episodes being the most common (38.9%), followed by biliary stricture (19.5%). Tonsilitis and sepsis (n = 12, 8.1% for each) were the most frequent infections. Pediatric patients experienced higher rates of infection, rejection, and early poor graft function than adult patients (P < 0.001, P = 0.003, and P = 0.025, respectively). The median follow-up time was 6.5 (IQR: 2.6–10.6) years. The overall survival rate was 84.4%, the 5-year survival rate, 86.2%, and the mortality rate, 15.6%. Younger patients had significantly better odds of survival (P = 0.019) and patients who survived had significantly longer follow-up periods (P < 0.001). CONCLUSION Patients with end-stage liver disease in Bahrain shared characteristics with those from other countries. Since LT facilities are not available, an overseas LT has offered them great hope.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pediatric and adult liver transplantation in Bahrain: The experiences in a country with no available liver transplant facilities

Isa,

Alkharsi,

Khamis

et al. 2024

World J Transplant

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The impact of metabolic syndrome and prevalent liver disease on living donor liver transplantation: a pressing need to expand the pool

et al. 2015

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Survival Rate of Liver Transplantation in Asia: A Systematic Review and Meta-Analysis

Ghelichi-Ghojogh¹,

Rajabi²,

Mohammadizadeh³

et al. 2022

ijph

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Background: Liver transplantation is one of the most effective treatments for acute liver failure, chronic liver cirrhosis, and hepatocellular carcinoma. This study was implemented to evaluate the survival rate of liver transplant in Asia. Methods: Studies that investigated the survival rate of liver transplant were selected using a systematic search strategy in the following databases: Medline, Embase, Scopus, ProQuest, ISI Web of Science, and Cochrane to Nov 30th, 2020. Pooled survival rate and 95% confidence intervals were calculated using Der-Simonian and Laird method. Stata 16.0 (Stata Corp, College Station, TX, USA) was used for analysis. Results: One, 2, 3, 5, and 10-year survival rates of liver transplant were estimated to be 85%, 80%, 75%, 73%, and 71%, respectively. The results of the univariate meta-regression for defining the sources of heterogeneity for one-Year survival rate (SR) showed significant effects of bias (β high risk/ moderate risk =0.059, 95% CI: 0.002, 0.115, P-Value=0.04) and follow up time (β=-0.0002, 95% CI: -0.0003, -0.00, P-Value=0.02) on heterogeneity. Conclusion: The survival rate of liver transplant in Asia is comparable with the corresponding rate reported in the United States and Europe. This study provides a better view of the efficiency of medical cares, regarding liver transplantation. Medical care be enhanced to increase the survival of liver transplant patients.

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Liver Transplantation at KFSHRC: Achievement and Challenges

Cited by 5 publications

References 8 publications

Pediatric and adult liver transplantation in Bahrain: The experiences in a country with no available liver transplant facilities

Pediatric and adult liver transplantation in Bahrain: The experiences in a country with no available liver transplant facilities

The impact of metabolic syndrome and prevalent liver disease on living donor liver transplantation: a pressing need to expand the pool

Survival Rate of Liver Transplantation in Asia: A Systematic Review and Meta-Analysis

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