Liver Transplantation in Greek Patients: Epidemiological Data, Morbidity, and Mortality of 71 Patients from a Single Center With 6 Years of Mean Follow-up E. Tsochatzis, J. Koskinas, E.K. Manesis, and A.J. Archimandritis ABSTRACT Liver transplantation remains an underdeveloped technique in Greece; currently there is no information on outcomes in Greek patients. In this study, data were provided on the outcomes of liver transplantation in 71 patients with a mean follow-up of 6 (0.1 to 16) years in our center. Mean age at transplantation was 46  13 years, while the main cause for transplantation was hepatitis B (16 patients, 23%) or C (six patients, 8%) virus. In the first posttransplantation year, three patients died, while 18 (25%) required at least one hospitalization with a median stay of 30 days. At the end of follow-up, 56 patients (79%) are alive. The leading cause of death was de novo malignancies (40%), appearing at a mean of 5.2  3.3 years. Late adverse effects of immunosuppressive therapy included hypertension (42%), hyperlipidemia (24%), chronic renal failure (21%), and diabetes mellitus (24%). With the exception of diabetes, all the above abnormalities were significantly associated with cyclosporine-based but not with tacrolimus-based immuno- suppressive regimens. Relapse of primary disease in liver transplants occurred in 21 (29.6%) patients at a mean time of 1.5  1.4 years, of whom 67% were related to viral hepatitis. The quality of life (Karnofsky scale 1 to 6) was excellent in 64% of surviving patients, affordable in 21%, and poor in 15%. In conclusion, after 6 mean years, the majority of Greek liver transplant recipients conduct a normal life, although metabolic abnormalities are often observed. A national registry is needed to provide more solid evidence of outcomes. A LTHOUGH ORTHOTOPIC liver transplantation (OLT) has evolved as a widely accepted, applied method for the treatment of acute and chronic liver failure, few data are available on Greek patients. Currently, there is only one liver transplantation center in Greece to cope with the augmenting demand. The majority of patients are transplanted in foreign centers. Moreover, Greece is not part of the European Liver Transplant Registry. As a result, there is nothing known about the outcomes of Greek patients after OLT. This retrospective study presents data on 71 transplanted patients. Although liver transplantations are not performed in our hospital, it is a known reference center for liver diseases in Greece. PATIENTS AND METHODS Data from 71 patients (43 men, 61%), who had undergone OLT from 1989 to 2005 and followed for a mean of 6 (0.1 to 16) years, were retrospectively collected for analysis. A minority of patients (12 patients, 17%) had been transplanted in Greece; the remaining, abroad. Epidemiological data on the causes of transplantation and posttransplantation morbidity and mortality are provided. As re- gards morbidity, we assessed the number and total duration of hospital admissions during and after the first posttransplantation year. Late adverse effects of immunosuppressive therapy have been recorded in each patient, including arterial hypertension, renal impairment (de- fined as serum creatinine  1.7 mg/dL), diabetes mellitus, hyperlip- idemia (serum cholesterol  240 mg/dL and/or serum triglycerides  150 mg/dL), and dyslipidemia (low-density lipoprotein  120 mg/dL and/or high-density lipoprotein  35 mg/dL). Recurrence of primary disease on the transplanted liver has been also recorded. In order to diagnose metabolic abnormalities, rejection, or recurrence of primary liver disease, blood chemistry values were measured at least every 3 From the Hippokration General Hospital, 2nd Department of Internal Medicine, Athens, Greece. Address reprint requests to Dr John Koskinas, MD, Hippokra- tion General Hospital, 2nd Department of Internal Medicine, 114 Vassilissis Sophias Avenue, Athens 115 27, Greece. E-mail: koskinas@ath.forthnet.gr © 2007 by Elsevier Inc. All rights reserved. 0041-1345/07/$–see front matter 360 Park Avenue South, New York, NY 10010-1710 doi:10.1016/j.transproceed.2006.11.010 Transplantation Proceedings, 39, 1505–1507 (2007) 1505