Assessing living donor liver transplantation outcomes through international collaboration: The Dow University experience with “the transplantation society and international liver transplantation society (TTS-ILTS) paired transplant centres ” activi

Abstract

Objective: To compare the survival status and postoperative complications in liver transplant recipients in a tertiary care setting before and after the introduction of a collaborative programme. Method: The retrospective study was conducted at the Liver Transplant and Hepatopancreatobiliary Surgery Unit of the Dow University of Health Sciences, Karachi, and comprised data of patients who underwent liver transplantation between May 2015 and December 2024. The Transplantation Society and International Liver Transplantation Society (TTS-ILTS) paired transplant centers  was introduced in September 2023, and, as such, patients who underwent the operation till August 2023 were placed in group A, and the rest were placed in group B. Patient characteristics, including demographics, operative details and postoperative complications, were compared between the groups. Data was analysed using SPSS 22. Results: Of the 177 patients, 124(70.1%) were in group A; 101(81.5%) males and 23(18.5%) females with median age 45 years (interquartile range: 35-52 years). There were 53(29.9%) patients in group B; 41(77.4%) males and 12(22.6%) females with median age 44 years (interquartile range: 38-52 years) (p>0.05). Postoperative complications, like pleural effusion and postoperative pneumonia, were significantly lower in group B compared to group A (p<0.05). The estimated survival rates at 1, 3 and 12 months were higher in group B, but the difference was not significant (p>0.05). Conclusion: The introduction of the collaborative programme had a positive impact on the outcomes of liver transplant cases.

Key Words: Living donor liver transplantation, LDLT, Survival outcomes, Postoperative complications, Mentoring, Learning curve.