LIVER - OUTCOMES

V.L. Pannain¹, J.B. Monteiro², J.V. Paschoal¹, J. Ribeiro filho¹, E. Fernandes¹, A. Caroli-bottino^2
1Pathology, Federal University of Rio de Janeiro, Rio de Janeiro/BRAZIL, ², Federal University of Rio de Janeiro, Rio de Janeiro/BRAZIL

Body: Introduction: Orthotopic liver transplantation (OLT) is an established method of treating serious hepatic diseases, including fulminant hepatitis, advanced liver cirrhosis and hepatocellular carcinoma (HCC). The study of the explanted organ is important because it often adds findings or even changes the previous diagnosis. We described the main diagnoses of explants livers in University Federal Hospital - Rio de Janeiro (liver transplantation center). Methods: The diagnoses obtained by examining the explanted livers from patients undergoing OLT between 1998 and 2008 were analyzed with respect to the frequency of the underlying diseases. The frequency of the HCC was compared between the period before and after the introduction of the model of end-stage liver disease (MELD) for organ allocation, in June 2006. Results: A total of 306 explants cases were examined. The main underlying diseases were: HCV infection(47.4%), cryptogenic(7.5%), alcohol(7.5%), autoimmune hepatitis-AIH(4.9%), primary sclerosing cholangitis(4.2%), HBV infection(3.3%) and familial paramiloidosis(3.3%). Of the total number of explants, 74.2% presented cirrhosis of various etiologies: HCV-63%, alcohol-10.1%, cryptogenic-9.7%, AIH-6.2% and HBV-4.4%. HCC was found in 40.9% of the cirrhotic livers. In the pre-MELD era, 242 OLT were carried out and HCC was diagnosed in 61 explants, corresponding to 25.2% of the total explants and 34.3% of the cirrhotic organs. Meanwhile, in the MELD era among 64 OLT, cirrhosis was found in 49 explants and HCC in 32 explants representing the double of the frequency in the previous period. Conclusion: As in other liver transplant centers, cirrhosis caused by VHC was the main cause of OLT in a center in Rio de Janeiro/Brazil. The substantial increase in the frequency of HCC in explants after introduction of the MELD reflects the changes in the criteria for organs allocation.

Disclosure: All authors have declared no conflicts of interest.