From March, 1979 to March, 1983,26 orthotopic liver transplantations and 1 retransplantation were performed in our center. Sixteen patients are alive, 5 beyond 2 years and 1 longer than 4 years after transplantation. The actuarial 1-and 2-year survival is 60%. Factors contributing to this result are patient selection and biliary anastomosis. In cirrhotic patients, the degree of deterioration of liver function correlated with survival; in patients with hepatocellular carcinoma, extrahepatic spread of tumor was the most frequent limiting factor. Choledochocholedochostomy with a widening plasty had a low complication rate providing that the arterial blood supply was undisturbed. Until now, HLA-matching has not contributed to the result of liver transplantation, although the effect for long-term survival is still unknown. The high survival rate and excellent quality of life of long-term survivors justify liver transplantation as treatment for otherwise noncurable liver diseases.
Although preparation for a program of orthotopic liver transplantation (OLT) in Groningen started in October, 1977, it was March, 1979 before the first OLT was performed (1). Presently, 4 years later, 26 patients have been transplanted. This report surveys the medical and surgical management of these patients. Factors influencing these results and the course of patients who were not accepted as a candidate are discussed.