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01.05.2016 | ICS congress 2015 | Sonderheft 2/2016

European Surgery 2/2016

Solid organ transplantation—where we are and how far can we possibly go?

Zeitschrift:
European Surgery > Sonderheft 2/2016
Autor:
MD PhD FRCS FICS FEBS MHA Jiri Fronek
Wichtige Hinweise
The supplement is dedicated to Jubilee World congress of International College of Surgeons 2015.
The publishing was sponsored by the Ministry of Health of the Czech Republic.

Abstract

Background

Solid organ transplants, e. g., kidney, pancreas, and liver, are well-established transplant methods at the Institute for Clinical and Experimental Medicine (IKEM), Czech Republic. Looking at the waiting lists, results, and also population in detail, some patients still suffer.

Methods

For the described reasons we have introduced some novel transplant methods since the second half of 2011. Kidney patients stay on dialysis; few get the best treatment method, which is live-donor kidney transplantation. Therefore, the live-donor program has been reorganized, kidney paired donation program introduced, miniinvasive donor nephrectomy used in all cases. Some liver patients suffer as well, especially small adults and children, also fulminant liver failure cases and those with multivisceral thrombosis. For these groups of patients we have introduced split-liver transplantation, ABO incompatible (AB0i) liver transplantation, live-donor liver transplantation, auxiliary liver transplantation, and also small bowel/multivisceral transplantation.

Results

Thanks to the changes, the number of live-donor kidney transplants has increased, the number of liver transplants doubled, many fulminant liver patients survived thanks to AB0i and auxiliary transplantation, and pediatric liver cases waiting time dropped dramatically. The small bowel transplant program started successfully with two multivisceral cases.

Conclusion

The novel methods and some program changes led to more transplants and also better outcomes. There is still room for further expansion and developments; there are for sure more transplant methods to be introduced. Also, the number of some transplants, e.g., live-donor kidney, still remains low.

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