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    Hepatic arterial reconstruction using saphenous vein graft interposition for living donor liver transplantation
    Batsaikhan BAT-ERDENE*, Bat-Ireedui BADARCH, Sergelen ORGOI, Erdene SANDAG, Batsaikhan BATSUURI, Urnult GANBOLD, Otgonbayar SETEVDORJ. Ann Hepatobiliary Pancreat Surg 2023;27:S313. https://doi.org/10.14701/ahbps.2023S1.EP-46
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    Study of risk factors for anastomosis and non-anastomosis biliary strictures after liver transplantation
    (2022-11-14)
    Undarmaa Zandanbazar
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    BatIreedui Batdarch
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    Background: In Mongolia 2020, there are 1,414 respiratory diseases, 1,833 gastrointestinal diseases, 1,268 cardiovascular diseases, 1,084 urogenital diseases, 598 injuries, poisonings and other external diseases per 10,000 population in our country, and compared to 2019, the leading causes of diseases are decreased by 12,685. As of 2020, there were 353 cases of acute hepatitis virus infection nationwide, which is 1.1 per 10,000 population, which is 1.1% of the total infectious diseases. Compared to last year, the number of reported cases decreased by 174 cases or 0.6 per 10,000 population. Methods: The survey will be conducted among 155 clients who underwent liver transplant surgery between March 2011 and April 2022, based on the Organ Transplant Center of the Ulaanbaatar City Hospital, with the approval of the Ethics Committee. Results: Regardless of the type of grafts or biliary reconstruction, the overall incidence of BC's in recipients ranges from 7.4% to 25%; leaks occur in 5%-18%, Pand strictures occur in 6%-20%. Conclusions: Anastomosis and non-anastomosis stenosis after liver transplant surgery are affected by the duration of warm and cold ischemic time, stenosis and occlusion of the hepatic artery.
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    P.402: The role of complement C4 and Alt level for acute rejection after liver transplantation.
    Acute liver graft rejection is still a common complication after liver transplantation. Diagnosis of acute cellular rejection (ACR) requires a liver biopsy with attendant expense, and risk, especially for developing countries. Measurements of serum complement components C3 and C4 are useful in the diagnosis and monitoring of immune complex disease. The normal adult range of C4 is 20-50mg/dl. Low levels of C4 strongly suggest immune complex disease. The combination C4 and ALT levels are highly predictive of acute cellular rejection (ACR) in liver transplant recipients. A lowered concentration or the complete absence of C4 occurs in immunocomplex diseases, systemic lupus erythematosus (SLE), autoimmune thyroiditis and juvenile dermatomyositis. Patients and Methods: Our study has two groups, one group comprised 8 liver transplant recipients, who has predictive diagnosis of ACR. The other group comprised 8 liver transplant recipients, who has not prediction of ACR. Pathologist evaluated the ACR by Banff grading schema. Serum C4 was checked Cobas 6000/c501/ analyzer. Results: ACR patients had an average of C4 ≤ 0.22 gm/L test, ALT ≥ 124 IU/ml. The patients without ACR had an average of C4 ≥0.61 gm/L test, ALT ≤ 87 IU/ml. The ACR patients had done needle biopsy, which showed liver rejection.Conclusion: To detect serum C4 in blood is a relatively non-invasive, inexpensive, easy to measure and quick marker. Especially for developing countries like Mongolia, preliminary diagnosis of ACR, which revealed decreasing C4 and increasing ALT convenient to biopsy results. Organ Transplantation Team of Mongolia.
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    P.367: Outcomes of liver transplantation: A single-center experience. (First Central Hospital of Mongolia).
    Methods: This study was conducted in Transplantation Center of the First Central Hospital of Mongolia between September 2011 and May 2023 on a total 200 patients have undergone liver transplantation. Results: There were 105 female patients out of 200, age between 18 months to 62 years old, and the average MELD score was 15±5.5, length of hospital stay were 31±13.94. These transplants were for liver (living donor=189, deceased donor=11, pediatric=7). The most causes of liver transplantation were liver cirrhosis due to HBV/HDV (59.5%), hepatocellular carcinoma (22.5%), primary biliary cirrhosis (5%), and only HBV related cirrhosis, alcoholic cirrhosis. There were 23(11.5%) biliary complication, 17 (8.5%) acute cellular rejection, hepatic artery thrombosis 2 (1%), and 3 cases retransplanted. The five year survival was 87%. Conclusions: This study provides the process of liver transplantation in First Central Hospital of Mongolia, and these positive outcomes support LT as an important therapy for end-stage liver disease and early hepatocellular carcinomas. Introduction: Liver transplantation (LT) is a main treatment of end-stage liver disease. Specially developing country like Mongolia has high prevalence of HBV, HDV, and hepatocellular cancer. Liver transplant is the second-most common solid organ transplant procedure in Mongolia. This study aimed to evaluate the efficacy of liver transplantation in the First Central Hospital of Mongolia.
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    A decade of liver transplantation in Mongolia: Economic insights and cost analysis
    (Springer Science and Business Media LLC, 2024-07) ; ; ; ;
    Ganbold, Urnultsaikhan
    BACKGROUND: Mongolia introduced liver transplantation 10 years ago, becoming the 46th country globally to successfully perform this procedure. However, the cost of liver transplantation treatment remains expensive in Mongolia, a lower-middle-income country. Thus, the need to calculate the cost of liver transplants, a highly-valued treatment, forms the basis for this study. METHODS: This study employed a retrospective research design with secondary data. The primary dataset comprised 143 cases of liver transplantation performed at the First Central Hospital of Mongolia between 2011 and 2021. RESULTS: The average cost of a liver transplant in Mongolia is $39,589 ± 10,308, with 79.6% being direct costs and 20.4% indirect costs. Of the direct costs, 71% were attributed to drugs, medical equipment, and supplies, while 8.6% accounted for salaries. In terms of the Model of End-Stage Liver Disease (MELD) scores, treatment costs were $39,205 ± 10,786 for patients with MELD ≤ 14 points, $40,296 ± 1,517 for patients with MELD 15-20 points, $39,352 ± 8,718 for patients with MELD 21-27 points, and $39,812 ± 9,954 for patients with MELD ≤ 28 points, with no statistically significant difference (P = 0.953). However, when calculated according to the Child-Turcotte-Pugh (CTP) score classification, treatment cost for CTP-A patients was $35,970 ± 6,879, for CTP-B patients $41,951 ± 12,195, and for CTP-C patients $37,396 ± 6,701, which was statistically significant (Р=0.015). CONCLUSION: The average cost of liver transplantation treatment in Mongolia was $39,589. Despite medical facilities' capacity to treat up to 50 patients annually, the waiting list exceeds 300 individuals, highlighting significant unmet healthcare needs.
    Scopus© Citations 2