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Liver transplantation is gaining in numbers in Malaysia although the numbers remained low in comparison to many regions around us. In Malaysia, there exists both DDLT and LDLT programs. The first liver transplantation surgery ever performed in Malaysia was in fact a living related donor liver transplantation in a private institution concerning a child with biliary atresia in 1994. This was followed by another successful LDLT in a Hospital Selayang, a public hospital, in 2002. Since then, liver transplantation has grown towards both LDLT and DDLT program in the public institution. In 2017, Universiti Malaya Medical Centre, UMMC, embarked on the LDLT program and successfully performed the first adult right liver lobe donation. The success of the program in this 2 centres would also lead to the opening of Hospital Tunku Azizah later, which offers both paediatric DDLT and LDLT later on. Malaysia have now 3 centres offering the public the service of a liver transplantation for those in with end stage liver disease.
Here, in UMMC, we would like to share our experience as a centre that runs mainly the LDLT program since 2017. We would like to share our donor outcomes as well as strategies undertaken by the team in ensuring donor safety and success in ensuring good outcomes in our LDLT program. Since 2017, we have performed up to 29 donor surgeries in taking various grafts from the right lobe, left lobe and left lateral of live donors. During this period, we have encountered 0% mortality during this period and morbidities encountered were superficial skin infection (n=13.45%), lung atelectasis (n=2, 6.9%), anaesthetic related issues (n=2, 6.9%), bile leak (n=1, 3.45%) and GI bleeding (n=1, 3.45%). Donor blood loss was a median of 500ml (IQR 400-800) and majority of patient stayed less than 14 days in hospital. Our results were comparable to most major centres in the early experience with regards to donor mortality and morbidity. |
