Studiul de faţă analizează experienţa Centrului de Chirurgie Generală şi Transplant Hepatic din Institutul Clinic Fundeni în transplantul hepatic ortotopic cu ficat întreg de la donator decedat la adult (THO), din aprilie 2000 până în aprilie 2006. În această perioadă au fost realizate 45 de THO – 20 femei şi 25 de bărbaţi, cu vârste cuprinse între 19-57 de ani (medie de 45 ani).Indicaţiile pentru transplantare au fost: ciroză VHB – 11, ciroză VHB VHD – 6, ciroză VHC – 13 (2 cu hepatocarcinom), ciroză VHB VHC – 2, ciroză VHB VHD etanol – 1, ciroză biliară primitivă – 5, boala Wilson – 2, ciroză toxic-nutriţională – 2, ciroza toxică non-alcoolică – 1, ciroză autoimună – 1, colangită sclerogenă primitivă – 1. Cu trei excepţii, la care s-a folosit tehnica clasică de transplantare, ficatul a fost grefat după tehnica Belghiti. Complicaţiile postoperatorii locale au survenit la 19 bolnavi (42,22%), iar generale la 19 (42,22%); complicaţiile tardive au fost înregistrate la 20 pacienţi (44,44%), iar recidiva bolii la 7 pacienţi (15,55%). Mortalitatea intraoperatorie şi postoperatorie imediată a fost de 6,66% (3 din 45 pacienţi). La peste 30 de zile de la TH, au decedat alţi cinci pacienţi (11,11%). Patru pacienţi (8,88%) au decedat la distanţă de momentul transplantului prin boală venoocluzivă, prin cancer bronho-pulmonar şi prin infarct miocardic -2. Patruzeci si doi de pacienţi au supravieţuit perioadei postoperatorii (93,33%) şi 33 peste un an (73,33%). THO reprezintă metoda principală de transplantare hepatică, cu o morbiditate şi mortalitate acceptabile.

Orthotopic liver transplantation in adult patients with cadaveric grafts – experience of the Fundeni Center of General Surgery and Liver Transplantation We analyze the experience of the Center of General Surgery and Liver Transplantation from the Fundeni Clinical Institute (Bucharest, Romania) regarding orthotopic liver transplantation (OLT) in adult recipients with whole liver grafts from cadaveric donors, between April 2000 (when the fi rst successful LT was performed in Romania) and April 2006. This series includes 45 OLTs in adult recipients (20 women and 25 men, aged between 19-57 years – average 45 years). The indications for OLT were HBV cirrhosis – 11, HBV HDV cirrhosis – 6, HCV cirrhosis – 13 (2 with hepatocarcinoma), HBV HCV cirrhosis – 2, primary biliary cirrhosis – 5, Wilson’s disease– 2, alcoholic cirrhosis – 2, non-alcoholic liver disease – 1, autoimmune cirrhosis – 1, HBV HDV alcoholic cirrhosis – 1, primary sclerosing cholangitis – 1. With three exceptions, in which the classical transplantation technique was used, the liver was grafted following the technique described by Belghiti. Local postoperative complications occurred in 19 patients (42.22%) and general complications in 19 (42.22%); late complications were registered in 20 patients (44.44%) and recurrence of the initial disease in 7 patients (15.55%). Intra- and postoperative mortality was 6.66% (3/45). There were fi ve patients (11.11%) who died at more than 30 days following OLT. Four patients (8.88%) died lately because of liver veno-occlusive disease, myocardial infarctions (2), and lung neoplasia, respectively. Forty-two patients survived the postoperative period (93.33%) and 33 (73.33%) survived more than one year following OLT. OLT represents the main method of liver transplantation, associated with acceptable morbidity and mortality rates.