الفهرس 
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Abstract
Living related liver transplantation is a well accepted therapeutic
option for patients with end-stage liver disease caused by variable disease
processes like, chronic viral hepatitis (in particular hepatitis C,B virus
infection), early-stage hepatocellular carcinoma, hepatoblastoma, Budd–
Chiari syndrome, and primary sclerosing cholangitis, Despite long-term
graft survival after liver transplantation continue to improve, reaching
over 70% at 5 years, the allograft may be affected by the original disease.
Although the initial concern about recurrent disease mainly related
to viral hepatitis, recurrence of nonviral liver disease has been shown to
lead to graft failure in a proportion of recipients, The rates and severity of
disease recurrence are highly variable and are probably related to the
complex interplay of host factors, iatrogenic influences, and possibly
genetic variability of the allograft. Accordingly, treatment options of
recurrent disease vary widly according to severity of recurrent disease,
and its effect on the recepient and his graft.
This study aimed at Assessment of factors responsible for disease
recurrence after living-related liver transplantation in the National Liver
Institute. And the effect of this recurrence, and its management on the
outcome of liver transplantation. Sixty nine patients underwent LDLT in
our institute from the start of LDLT program at 28 April 2003 until the
end of December 2009. After exclusion of early death (hospital
mortality), the present retrospective study included fourty five patients.
Data were extracted from preoperative records, operative data
records, post-operative patients files and from follow up records of all
patients.
I- Preoperative data (24 hours before LT.) which included:
-Donors variables( Age, gender…..).
-Recipients variables:
1-Preoperative variables(Demographic findings,indication of liver
transplantation, scoring systems……… )
2- Intraoperative variables (Duration of operation ( per hours),total
time of recipient operation, graft weight( actual intraoperative
weight…….).
3- Postoperative variables:
a- Postoperative treatment protocol(The standard immunosuppresion
and steroid regimen, Anticoagulants……..)
B- postoperative follow up protocol:
C- Postoperative complications:
d-Long term Follow up data:
1-Primary disease recurrence( HCV recurrence, HCC
recurrence……)
2-Long term mortality rate.
The fourty five patients were classified according to age into
pediatrics <18 years, and adults >18 years:
I- The pediatric group: They were fourteen patients(31.1%).
II- The adult group: They were thirty one patients(68.8%).
In pediatric group, the incidence of recurrence of primary disease
was 1/14(7.1%), this case was Budd Chiari syndrome.The all pediatric
mortality was 4/14((28.6%).
In adult group the incidence of recurrence was 15/31(48.4%) of
patients. It was distributed according to the aetiology as follow:
10/17(58.8%) had recurrence in HCV patients, 3/8(37.5%) in HCC
patients, and 2/2 (100%) in PSC patients. The mortality of all, non
recurrent, and recurrent adults were 16.1%, 6.3%, and 26.7%
respectively.