Introduction: Liver transplantation (LT) is a critical medical procedure that has traditionally been performed at high-volume centers, but smaller centers have also begun to offer LT due to advancements in technique and increasing demand. While this expansion has made the procedure more accessible, there are concerns about the safety and effectiveness of LT at small-volume centers. This study aims to analyze the initial experience of LT at single center.
Methods: Between July 2014 and September 2021, 60 adults underwent LT at Bucheon Saint Mary’s Hospital. The overall outcomes were analyzed in terms of perioperative outcomes, complications, and overall survival rate. In addition, the patients were divided into a living donor liver transplantation (LDLT)) group (n =26) and a deceased donor liver transplantation (DDLT) group (n = 34). The baseline characteristics, perioperative outcomes, complications, and overall survival rate were analyzed between the two groups.|
Results: Out of the 60 patients, 44 were in the benign end-stage liver disease (ESLD) group, and 16 were in the hepatocellular carcinoma (HCC) group. Within the HCC group, 12 (46.2%) were in the LDLT group and 4 (11.8%) were in the DDLT group (p-value = 0.003). The 1-year, 3-year, 5-year survival rates were 86.7%, 79.7%, and 77.7%, respectively. The 1-year, 3-year, and 5-year survival rates in the LDLT group were 96.2%, 92.3%, and 92.3%, respectively, compared to 79.4%, 70.0%, and 66.5% in the DDLT group. The overall survival difference was not statistically significant between the two groups (p-value = 0.06).(Figure 1.)
Conclusion: The study found that the outcomes of LT at a small-volume center were comparable in both the LDLT and DDLT groups, with no statistically significant differences in overall survival between the two groups. We suggest that with appropriate patient selection and adequate resources, LT can be safely performed at small-volume center, expanding access to this life-saving procedure.