The first successful liver transplant in Sri Lanka

Wijeyaratne, Mandika; Gunawansa, Nalaka; Cassim, M R N; Abayadeera, Anuja

doi:10.4038/cmj.v56i2.2381

Cited by 5 publications

(6 citation statements)

References 3 publications

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“…The first PLT was performed 10 years after the first successful adult liver transplant in SL [5] and reflects the challenges faced by a fledgling transplant program. The challenge was to bring together liver surgeons, adult and paediatric anaesthetists, paediatric hepatologists, interventional radiologists and liver-trained pathologists, who worked in different parts of the country, under one umbrella.…”

Section: Discussionmentioning

confidence: 99%

“…The history of paediatric liver transplant dates back many decades in affluent countries with over 85% five-year survival being reported worldwide [3,4]. This first successful paediatric liver transplant in Sri Lanka [SL] was performed in 2020, a decade after the first adult liver transplant was performed in SL [5]. We share our experience of the first PLT at the completion of the first post-transplant year while looking at how the future for a sustainable PLT programme could be achieved in the country.…”

Section: Introductionmentioning

confidence: 99%

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First paediatric live donor liver transplant in Sri Lanka with 1 year outcome : challenges for the future

et al. 2021

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IntroductionLiver transplantation in the paediatric age group is demanding due to smaller body proportions and physiology. This paper describes the first successful paediatric liver transplant in Sri Lanka along with its one-year outcome. Describing the challenges faced during the process, we highlight the factors that need to be considered for a sustainable programme in the future. MethodologyA 9-year-old girl who had progressive familial intra hepatic cholestasis type 3 was referred to us with features of end stage liver disease. She was identified as a suitable candidate for liver transplantation. Her 38-year-old mother was selected as the donor, who was evaluated for suitability of a left lateral segment donation. ResultsThe first paediatric liver transplantation was performed in July 2020. The child's mother donated the left lateral segment weighing 325g. During the postoperative period the child developed outflow tract obstruction at the hepatic venous anastomosis. This was managed with a percutaneously placed stent. Six months after transplant, she developed an acute rejection that required steroids. Treatment of rejection was complicated with multiple liver abscesses caused by Aspergillus. The infection was treated with systemic antifungals and drainage. At one-year post transplant, the recipient had recovered from the trauma of surgery and had normal liver biochemistry, a patent hepatic venous stented anastomosis and complete resolution of the abscesses. We faced dual challenges in dealing with a live liver transplant donor and a young child who was the recipient. Our success, on this occasion, was underscored by the multidisciplinary contribution from specialists scattered across the island combined with state-public partnership.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

First paediatric live donor liver transplant in Sri Lanka with 1 year outcome : challenges for the future

et al. 2021

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“…Sri Lanka carried out its first successful cadaveric LT in 2010, followed by the first live-donor transplant in 2012, the first transplant for acute liver failure in 2018 and the first successful paediatric transplant in 2020 [20,21]. As of 2021, 22 liver transplantations have been conducted in the country [12].…”

Section: Liver Transplantation In Sri Lankamentioning

confidence: 99%

Challenges of liver transplantation programs in low‐ and middle‐income countries: An experience from Sri Lanka

Jayarathna,

Dassanayake,

Dorji

et al. 2024

Public Health Challenges

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Liver diseases lead to 1.3 million deaths per year around the world, the majority of which are secondary to cirrhosis. In the management of liver diseases in chronic and acute conditions, liver transplant (LT) plays a major role in improving the survival and quality of life of patients. LT programmes require the technical capabilities in performing the pre‐transplant evaluation, transplant surgery and post‐transplant care supported by adequate infrastructure and a set of trained teams. Globally, there were 28,000 deceased donor LTs, and 14,000 living donor LTs were performed in 2021. In the South Asia region, India, Pakistan and Sri Lanka conducted 2998 LTs in 2021. Many countries report sociocultural, religious and legislative barriers to acquiring adequate donor livers. We describe the challenges in LT programmes in low‐ and middle‐income countries and experiences from Sri Lanka. Sri Lanka carried out its first LT in 2010, and the service is provided free of charge in the state health sector. In Sri Lanka, the common indications for LT in adults are non‐alcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma and alcoholic liver disease. In children, the indications are biliary atresia, hepatocellular carcinoma and Wilson disease. The common challenges include a lack of an adequate number of doctors and post‐transplant team members, a low number of organ donors and a long waiting list, all of which can be disadvantageous for transplant programmes. To continue providing LT services, there is a need to adopt multimodal strategies in the areas of providing additional skills training to the operating team and promoting organ donation culture in the background of supportive organ donation legislation. With the adoption of the national strategic plan for organ, tissue and cell transplantation, the country hopes to strengthen its capacity of providing transplant services to its people.

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“…In Sri Lanka, the first successful cadaveric liver transplant was carried out in 2010 [8]. The team from the Colombo North Centre for Liver disease carried out the first live donor liver transplant in 2012 followed by the first liver transplant for acute liver failure in 2017 [9].…”

Section: Evolution Of Liver Transplant Surgerymentioning

confidence: 99%

Fifty liver transplants: a single centre experience of haemodynamic management in liver transplantation for cirrhosis [part 1]

Gunetilleke¹,

Ranamuni²,

Jayaweera³

et al. 2021

Sri Lanka j Surg

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Cirrhosis with end stage liver disease (ESLD) is a leading cause of non-communicable disease related deaths in Sri Lanka. Liver transplantation is the only curative treatment for patients with ESLD. The complex multisystem involvement and unique cardiovascular profile characteristic of ESLD present formidable challenges during liver transplantation. Management of the rapid and varied hemodynamic changes during surgery requires an in depth understanding of the physiological effects of each intervention. Based on the current literature and the experience gained at our center during the management of 50 liver transplants, we present optimization strategies and perioperative hemodynamic interventions which we use to 'Fast track' recovery following liver transplantation.

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The first successful liver transplant in Sri Lanka

Cited by 5 publications

References 3 publications

First paediatric live donor liver transplant in Sri Lanka with 1 year outcome : challenges for the future

First paediatric live donor liver transplant in Sri Lanka with 1 year outcome : challenges for the future

Challenges of liver transplantation programs in low‐ and middle‐income countries: An experience from Sri Lanka

Fifty liver transplants: a single centre experience of haemodynamic management in liver transplantation for cirrhosis [part 1]

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