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Evolution Of The Results Of 1500 Liver Transplantations Performed In The Department Of General, Transplant And Liver Surgery Medical University Of Warsaw

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Krawczyk M., Grąt M., Grąt K., Wronka K., Krasnodębski M., Stypułkowski J., Masior Ł., Hołówko W., Ligocka J., Nyckowski P., Wróblewski T., Paluszkiewicz R., Patkowski W., Zieniewicz K., Pączek L., Milkiewicz P., Ołdakowska-Jedynak U., Najnigier B., Dudek K., Remiszewski P., Grzelak I., Kornasiewicz O., Kotulski M., Smoter P., Grodzicki M., Korba M., Kalinowski P., Skalski M., Zając K., Stankiewicz R., Przybysz M., Cieślak B., Nazarewski Ł., Nowosad M., Kobryń K., Wasilewicz M., Raszeja-Wyszomirska J., Piwowarska J., Giercuszkiewicz D., Sańko-Resmer J., Rejowski S., Szydłowska-Jakimiuk M., Górnicka B., Wróblewska-Ziarkiewicz B., Mazurkiewicz M., Niewiński G., Pawlak J., Pacho R.

Polish Journal of Surgery

2015

vol. 87

issue 5

221-230

Liver transplantation is a well-established treatment of patients with end-stage liver disease and selected liver tumors. Remarkable progress has been made over the last years concerning nearly all of its aspects. The aim of this study was to evaluate the evolution of long-term outcomes after liver transplantations performed in the Department of General, Transplant and Liver Surgery (Medical University of Warsaw). Material and methods. Data of 1500 liver transplantations performed between 1989 and 2014 were retrospectively analyzed. Transplantations were divided into 3 groups: group 1 including first 500 operations, group 2 including subsequent 500, and group 3 comprising the most recent 500. Five year overall and graft survival were set as outcome measures. Results. Increased number of transplantations performed at the site was associated with increased age of the recipients (p<0.001) and donors (p<0.001), increased rate of male recipients (p<0.001), and increased rate of piggyback operations (p<0.001), and decreased MELD (p<0.001), as well as decreased blood (p=0.006) and plasma (p<0.001) transfusions. Overall survival was 71.6% at 5 years in group 1, 74.5% at 5 years in group 2, and 85% at 2.9 years in group 3 (p=0.008). Improvement of overall survival was particularly observed for primary transplantations (p=0.004). Increased graft survival rates did not reach the level of significance (p=0.136). Conclusions. Long-term outcomes after liver transplantations performed in the Department of General, Transplant and Liver Surgery are comparable to those achieved in the largest transplant centers worldwide and are continuously improving despite increasing recipient age and wider utilization of organs procured from older donors.

Signalling: basics and evolution.

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Williams R. J. P.

vol. 51

issue 2

281-298

Signalling concerns the transfer of information from one body, a source, to another, a receiver in order to stimulate activity. The problem arises with the word information. It is defined as what is transferred in a sequence of things, say between people, e.g. words or signs. The idea of signalling between people is then obvious but it is not clear in cell biology. Information transfer, signalling, is required for the organisation of all cellular activity but we must ask what is transferred and how is it transmitted and received? Sometimes it is assumed that all information, i.e. organisation in a cell, is represented in the DNA sequence. This is incorrect. We shall show that the environment is a second source of information concerning material and energy. The receiving party from both DNA and the environment is general metabolism. The metabolism then signals back and sends information to both DNA and uptake from the environment. Even then energy is needed with machinery to send out all signals. This paper examines the way signalling evolved from prokaryotes through to man. In this process the environmental information received increased to the extent that finally the brain is a phenotypic as much as a genotypic organ within a whole organism. By phenotypic we mean it is organised by and interactive with information from the environment.

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Evolution Of The Results Of 1500 Liver Transplantations Performed In The Department Of General, Transplant And Liver Surgery Medical University Of Warsaw

Signalling: basics and evolution.