Orthotopic liver transplantation at king faisal specialist hospital and research center: 1994-1995.

Over the last decade, orthotopic liver transplantation (OLT) has become an established therapy for end-stage liver disease of various etiologies. The early experience with orthotopic liver transplantation in the Kingdom was in 1990 in the Military Hospital when a man with sclerosing cholangitis received a new liver successfully. Intensive effort was done at King Faisal Specialist Hospital and Research Center (KFSH & RC) to start liver transplantation and that was achieved in March 1994 when a man with an end-stage liver failure secondary to hepatitis C was transplanted successfully. Since then, forty four (44) more liver transplantations were done at KFSH & RC. The age of the patients transplanted ranged from 9-65 years old; there were more males than females, (26 males, 15 females). The waiting time until transplantation was up to one year. All patients received a combination of cyclosporin and prednisolone as an induction therapy +/- Azathioprime. The majority of patients developed minor complications like wound infection and acute mild cellular rejection. In the second year, 3 out of 18 patients also developed primary non-function. Also in the first year, the majority of the patients developed primary dysfunction; however, this decreased significantly in the second year. The majority of the patients who were transplanted for hepatitis C had mild recurrence. None of them lost their livers because of recurrence of hepatitis C. Several patients developed biliary complications including bile leak and stricture at duct-to-duct anastomosis.