Clinical Outcomes for Saudi and Egyptian Patients Receiving Deceased Donor Liver Transplantation in China

Long waiting list times in liver transplant programs in Saudi Arabia and unavailability of deceased donor transplantation in Egypt have led several patients to seek transplantation in China. All patients who received transplants in China and followed in three centers from January 2003–January 2007 were included. All patients’ charts were reviewed. Mortality and morbidity were compared to those transplanted in King Faisal Specialist Hospital & Research Centre (KFSH&RC) during the same period. Seventy‐four adult patients were included (46 Saudi nationals; 28 Egyptians). One‐year and 3‐year cumulative patient survival rates were 83% and 62%, respectively compared to 92% and 84% in KFSH&RC. One‐year and 3‐year cumulative graft survival rates were 81% and 59%, respectively compared to 90% and 84% in KFSH&RC. Compared to KFSH&RC, the incidence of complications was significantly higher especially biliary complications, sepsis, metastasis and acquired HBV infection posttransplant. Requirements of postoperative interventions and hospital admissions were also significantly greater. Our data show high mortality and morbidity rates in Saudi and Egyptian patients receiving transplants in China. This could be related to more liberal selection criteria, use of donation after cardiac death (DCD) donors or possibly more limited posttransplant care. Patient and graft survival rates are low in Saudi and Egyptian patients receiving liver transplantation compared to those transplanted locally. See Editorial by Fung on page 1723.