Outcome for Hong Kong residents undergoing cadaveric liver transplantation in mainland China

Abstract

Objective. To review the outcome for Hong Kong residents undergoing cadaveric liver transplantation in mainland China. Design. Retrospective study. Setting. Liver Transplant Centre, university teaching hospital, Hong Kong. Subjects and methods. A retrospective review of medical records was undertaken for patients at Queen Mary Hospital who underwent cadaveric liver transplantation in China between 1 January 1997 and 31 December 2001. Results. Fifteen patients from Queen Mary Hospital underwent cadaveric liver transplantation in China during the study period. Eleven were men and four were women. Their mean age was 51 years. Disease indications included hepatitis B-related liver cirrhosis (n=7), hepatitis B-related liver cirrhosis with hepatocellular carcinoma (n=5), hepatitis C-related liver cirrhosis (n=1), hepatitis C-related liver cirrhosis with hepatocellular carcinoma (n=1), and polycystic liver and kidney disease (n=1). Nine patients were already waiting for liver transplantation at Queen Mary Hospital, and two of the nine patients were on the 'urgent' list. The overall survival rate was 80.0% at 6 months and 73.3% at 12 months. There were four (27%) deaths, two of which occurred in China. Of the 11 surviving patients, nine (82%) developed complications. Nineteen complications were seen in the 13 patients who were managed in Hong Kong following their return from China. Infective and biliary complications accounted for 58% and 26% of complications, respectively. Major complications necessitated prolonged hospitalisation for four patients and two required further laparotomy. Conclusion. Although cadaveric liver transplantation in China is an option for Hong Kong residents, patients and clinicians should be aware of the possible outcomes and resource implications.