The Hospital Clinic of Barcelona has long being a reference in liver diseases. His Liver Unit is a well recognized center all over the world. Since the start of the liver transplantation program in 1988, our group has increased his activity, being among the most active centers in liver transplantation in Europe maintaining an overall long term survival results, well over the European mean value (European Liver Transplant Registry). At the same time we have progressively increase the number of hepatobiliopancreatic procedures performed at the clinic, including laparoscopic liver resections. After a period of almost 30 years more than 2000 liver transplants, including 105 adult living donor liver transplantations and more 1800 highly complex liver resections have been performed (apart from simple straight forward procedures).
The increasing activity in HBP Surgery during the past years, has allowed us to develop different types of procedures apart from the conventional liver transplantion. Among them, the use of livers from non heart beating donors, as well as starting in 2000 the first adult living donor liver transplantation program in Spain. Our long term result confirm the success of this type of transplantation achieving similar survival to that obtained after conventional cadaveric liver transplantation. A 99% survival rate at one year and 78% and 70% survival rate at 5 and 10 years. Besides we have been developing complex liver surgery procedures, specifically in relation to metastatic colorectal cancer liver disease (MCLD) and Hepatocellular Carcinoma (HCC). We perfomed around 250 liver resections and 80 liver transplantations each year.
Besides to the normal activity, we perform around 8-10 LDLT's each year. The usual indication is associated to Hepatitis B or C virus related problems, either Cirrhosis or Hepatocellular Carcinoma. Our group has designed an specific protocol in which extended indications beyond Milan Criteria are included. Specific care is taking in relation to the donor. Our results in the donor have been recently published and taking as the benchmarks for Major Liver Surgery.
Is one of the most frequent indications for liver Surgery, as long as the liver function remains stable. It includes surveillance of patients affected of hepatitis B or C virus, local or regional treatment in terms of Radiofrequency or Microwave ablation as well as transarterial chemoembolization. Surgery remains the gold standard treatment whenever is possible. Procedures contemplates the possibility of laparoscopic segmental liver resection.
Due to the high incidence in western countries of Colorectal cancer, metastatic liver disease is also one of the most important indications for liver surgery. As a reference center, the multidisciplinary approach includes a close relationship with our oncologists and radiologists in order to increase the possibility of a successful resection and recovery. This includes neoadjuvant as well as adjuvant chemotherapy, and/or portal embolization in order to increase the remnant liver volume.
The medical team is 100% dedicated to HOSPITAL. As a result, our patients are always seen by the same team of physicians and surgeons throughout the entire procedure.
Specially trained hospital nurses have extensive experience in the care of surgical or transplant patients with a nurse-to-patient ratio that is never more than 1:2.
For patients affected of HCC or MCCLD:· Specific Multidisciplinary Approach Evaluation. Hepatology, Interventional Radiology and Surgery |
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Donor Evaluation:· Overall health status including psychological evaluation · Specific Liver Evaluation. Vascular and Biliary Distribution. · Sequential donor evaluation, including a transparent and strict donation process |
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Specifically Designed and equipped Integrated Operating Theater (x2)· Performance of the transplant in parallel (independent OR's). - Right/Left Hepatic Donation/Retrieval - Patient Explant Hepatectomy and Implant |
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Strict Postoperative Follow up at ICU and Ward |
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Postrtansplant Long term Follow up of the donor and the patient |
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105Living Donor Liver Transplantation |
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99%First year |
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75%For 5 years |
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90%First year |
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70%For 5 years |
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+300HCC resected in the last ten years |
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75’6%Overall Survival at 5 years |
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38’6%Disease Free Survival at 5 years |
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+400Major Hepatectomies (2005-2015) |
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56,1%Overall Survival at 5 years |
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29,6%Disease Free Survival at 5 years |
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