Clinical study of patients with hepatic disease at a city hospital in Japan —Consideration on indications for liver transplantation—

One-hundred and ninety-one patients with liver diseases who were admitted to National Fukuoka Central hospital during a 3 years period between January 1, 1984 and December 31, 1986 were studied to assess the indications for liver transplantation with the use of a criteria by Dr. Van Thiel et al. The patients were divided into 2 groups; I-indication and II-no indication. Then group I was divided into 3 groups; A-no contraindication, B-relative-contraindication and C-contraindication. Of the 131 patients, group A and B which had the indication of liver transplantation without contraindication were 17%. Deaths by April 30, 1990 were as follows; I 62% (A 36%, B 86%, C 100%) and II 12%. Ten out of 13 deaths in Group I were all due to hepatic failure, while only 3 out of 8 deaths in Group II were due to hepatic failure. Of the other 60 patients with malignancy, 57 were hepatocellular carcinomas, and the other 3 were 2 metastatic hepatic cancers and cholangioma. Among the patients with hepatocellular carcinoma, 24 out of 46 died of cancer, while the other 19 patients died of hepatic failure. The criteria of the indication of liver transplantation seems acceptable for the evaluation of Japanese patients with non-malignant hepatic diseases. As to patients with hepatocellular carcinoma, a new and separate criteria is in need to evaluate them for liver transplantation.